A Case of an Intramural Cyst of the Gallbladder with Communication with the Gallbladder Lumen

Abstract

A 77-year-old man was admitted for liver dysfunction and gallstones found in abdominal US. A 3.0-cm cystic lesion at the neck of the gallbladder was also found on abdominal US. Contrast-enhanced CT and MRI also showed many stones in the gallbladder and a 3.0-cm cystic lesion at the neck of the gallbladder. A diagnosis of cholelithiasis and gallbladder adenomyomatosis was made, and laparoscopic cholecystectomy was performed. The resected specimen was a 4.0-cm cyst at the neck of the gallbladder, with communication between the gallbladder lumen and the cyst. An incision showed that the cyst was filled with clear mucus. Histologically, the cyst was an enlarged Rokitansky-Aschoff sinus, and the pathological diagnosis was an intramural cyst of the gallbladder. This kind of cyst is rare, with very few reports, and its clinical and histological features have not been established. There are no reports of cases in which communication between an intramural cyst of the gallbladder and the gallbladder lumen was confirmed, and therefore, the section was examined macroscopically and histologically in detail. We report this case as the first example of an intramural cyst of the gallbladder with communication with the gallbladder lumen.