A case of fibrous polyp of the gallbladder which presented difficulty in differential diagnosis from early gallbladder carcinoma is reported.
A 51-year-old man who was pointed out having an elevated lesion in the gallbladder at a medical checkup was admitted to the hospital. Abdominal ultrasonography (US) and endoscopic ultrasonography (EUS) visualized a polyp 22mm in maximum diameter in the fundus of the gallbladder; the surface of the polyp was irregular, and high echo line like outlining the surface and internally scattered, heterogenous low echo spots were seen. Since a possibility of early gallbladder carcinoma of type Ip with invasion depth of m could not be ruled out, a laparoscopic cholecystectomy was carried out. Histopathological studies of the resected gallbladder indicated that the lesion was fibrous polyp according to the WHO classification.
Fibrous polyp of the gallbladder is a rare entity and this case appeared to be the 26th report in Japan. In imaging diagnosis the disease often presents difficulty in differential diagnosis from gallbladder carcinoma. It is thought that the appropriate therapeutic guideline at present is to suspect any gallbladder tumor of the disease if characteristic findings are obtained with US and EUS, and then to select laparoscopic cholecystectomy actively to make the definitive diagnosis.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)