A Case of Gallbladder Neck Cyst

Abstract

In this report, we present a review of the literature concerning a rare case of cholecystitis with sludge and a cyst located in the wall of the gallbladder neck. The patient was a 78-year-old man who visited our hospital due to mild upper abdominal pain after breakfast. Laboratory findings revealed elevated levels of hepatobiliary enzymes (T-Bil 1.5 mg/dl, AST 63U/L, ALT 47U/L) and CRP (1.39 mg/dl). Abdominal ultrasonography demonstrated a thickened gallbladder wall, bile sludge in the gallbladder, and a cystic area in the wall of its neck, suspected to be a Rokitansky-Aschoff sinus. CT scan demonstrated mild wall thickening and enlargement of the swallen gallbladder. Subsequently, laparoscopic cholecystectomy was performed under the diagnosis of acute cholecystitis with gallbladder sludge and adenomyomatosis. Upon opening the resected gallbladder, a mucus-containing cyst less than 10 mm in diameter was found in the wall of its neck. Histopathological examination revealed it to be a dilation of an encapsulated glandular duct with no malignant findings. Gallbladder cysts are rare, and only 17 cases, including ours, have been reported in Japan. Nevertheless, in view of the possibility of cancer development, it is important to follow up patients closely for cyst expansion and not overlook the timing for surgery.