Clinicopathological features of gallbladder cancer with adenomyomatosis

Abstract

We evaluated clinical, pathological, and imaging features of the gallbladder cancer (GC) with adenomyomatosis (ADM). Eleven GC patients who received surgical treatment were with ADM. Their ADM type were fundal type (F type) in 5 and segmental type (S type) in 6. GCs with F type ADM occurred from the mucosa above ADM, excepted in one case in which cancer was speculated to arise from Rokitanski-Aschoff sinus. GCs with S type ADM were spread widely across the mucosa above ADM of the neck side to the fundal side, and gallbladder stones were found in those cases. Six (55%) of the 11 GC patients with ADM were appropriately diagnosed preoperatively, and imaging studies of their cases revealed elevated lesions on the surface of ADM in the early stage GC and irregular gallbladder wall thickening in the advanced stage. GC with ADM arose from the mucosa above ADM in F type, and from the mucosa above neck/body side ADM and those at fundal part of ADM in S type. Therefore, detailed imaging evaluation of the surface of ADM is important. Cases of S type ADM with gallbladder stones may be treated with surgical resection due to difficult diagnosis of GC by imaging study.