Gallbladder cancer presenting with a single giant common bile duct stone in a patient with normal cholestatic...

We present the case of a 65-year-old Ethiopian female with a 10.5 × 4 cm, 150 g giant CBD stone and normal cholestatic function tests. Ultrasound and contrast-enhanced CT scan suggested gallbladder cancer and a CBD stone with dilated intrahepatic and extrahepatic biliary trees. The patient was successfully managed with extended cholecystectomy, common bile duct exploration, stone extraction, and choledochoduodenostomy. Histopathology revealed adenocarcinoma of the gallbladder with negative margins. No tumor recurrence was noted on subsequent follow-up of 2 years. Giant CBD stones are rare, especially in Africa. Most patients present with abnormal cholestatic function tests and jaundice; however, presentation with normal cholestatic parameters is uncommon. The coexistence of gallbladder cancer and a giant CBD stone represents longstanding gallstone disease and chronic inflammatory changes that contribute to the development of gallbladder cancer.