A Case of Xanthogranulomatous Cholecystitis with Difficulty in Preoperative Diagnosis

Abstract

A 72-year-old woman was referred to our hospital with jaundice, right hypochondrial pain, and fever. Enhanced computed tomography revealed a greatly thickened gallbladder wall, a large gallstone (Φ33mm), and encasement of the right hepatic artery. Percutaneous transhepatic cholangiography revealed severe stenosis extending from the hilar bifurcation of the bile ducts to the common bile duct. Pathological examination of the gallbladder wall during surgery for gallstone ileus carried out 4 days after percutaneous transhepatic portal vein embolization led to a final diagnosis of xanthogranulomatous cholecystitis. Physicians need to be alert to the possibility of xanthogranulomatous cholecystitis, which is difficult to differentiate from advanced gallbladder cancer.