Xanthogranulomatous cholecystitis mimicking gallbladder cancer: Report of a case and review of Japanese literatures

Abstract

Xanthogranulomatous cholecystitis (XGC) is occasionally difficult to distinguish from gallbladder cancer because it involves infiltrative inflammation of the surrounding organs such as the duodenum, colon and liver. We recently experienced an XGC case. The patient was a 69-year-old male. He consulted a local clinic, complaining of weight loss. Diagnostic imaging revealed thickening of the gallbladder wall, and the patient was referred to us. At our department, a gallbladder mass contiguous with the duodenum was revealed by abdominal ultrasonography, CT and MRI. In addition, an incarcerated gallstone was identified at the gallbladder neck. Based on the diagnosis of gallbladder cancer, the patient underwent open surgery (full-thickness cholecystectomy). Intraoperative rapid pathological examination revealed no signs of malignancy. The final diagnosis was XGC. The patient suffered no complications and was discharged from the hospital on the 12th postoperative day. According to previous reports of cases with XGC in which distinguishing this disease from gallbladder cancer was difficult, incarceration of gallstones at the gallbladder neck is a common finding. We describe one case in which XGC was difficult to distinguish from gallbladder cancer preoperatively and discuss preoperative strategies for distinguishing between gallbladder cancer and XGC with reference to the literature.