2021 Volume 54 Issue 2 Pages 118-124
We present the case of a 69-year-old woman with an 18-mm mass revealed at the fundus of the gallbladder on abdominal US and an elevated lesion at the same site that was prematurely stained on contrast-enhanced CT. Based on suspected gallbladder carcinoma, laparoscopic cholecystectomy was performed. A mass consisting of solid and cystic components was found on the surface of the fundus of the excised gallbladder, and an intraoperative diagnosis of adenocarcinoma was made using frozen sections. Gallbladder bed resection and lymph node dissection were performed. Most of the tumor was in a dilated cyst, and the cystic epithelium had developed in a papillary and inverted manner. Moreover, infiltration into the subserosa was observed at the fundus of the solid component. The histological diagnosis was intracholecystic papillary neoplasm (ICPN) with an associated invasive carcinoma. The cyst was presumed to have originated from the Rokitansky-Aschoff sinus (RAS), which had filled with tumor-producing mucus that had expanded. An ICPN originating and progressing from the RAS is rare. We describe the case and a review of literature cases.
