A 54-year-old woman who had porcelain gallbladder with jaundice was referred to our hospital on suspicion of gallbladder cancer. Contrast-enhanced CT showed a mass lesion with poor vascularity between the hepatic hilum at the neck of the gallbladder. MRCP showed a stricture in the common hepatic duct. FDG/PET-CT showed strong accumulation in the mass lesion. Endoscopic retrograde cholangiography was performed with bile and tissue sampling and endoscopic ultrasound-guided fine-needle aspiration, but there was no evidence of malignancy. Peroral cholangioscopy showed inflammatory changes but no malignant findings, and pathologic evaluation of the cholangioscopy-guided targeted biopsy specimen also showed no evidence of malignancy. Inflammatory changes due to porcelain gallbladder were clinically diagnosed, and cholecystectomy was performed. The histopathological diagnosis was xanthogranulomatous cholecystitis with porcelain gallbladder. It is essensial to perform detailed investigations including histopathological examination of patients with gallbladder disease in order to distinguish non-cancerous disease from malignancy.
