Abstract
Xanthogranulomatous cholecystitis (XGC) is a subgroup of cholecystitis characterized by the presence of granulomatous nodules in the gallbladder wall. It is often difficult to differentiate XGC from severe inflammation and gallbladder carcinoma (GBC). Extended surgeries have been performed for the treatment of XGC mimicking GBC. However, GBC has also been reported in XGC. Therefore, such associated conditions should be carefully ruled out before selecting the surgical procedure. We faced difficulty in selecting the correct surgical procedure in two cases diagnosed as XGC with probable GBC. Both cases were men in their fifties with a chief complaint of pain in the right upper quadrant. A definitive diagnosis was not possible because CT and PET images showed the possible presence of GBC in the XGC with inflammation extending to the surrounding organs. Since the intraoperative findings revealed no adhesions attributable to GBC, extended resections of the gallbladder were performed. The excised specimens were diagnosed as XGC on histology.