A case of xanthogranulomatous cholecystitis distinguished from hepatic invasion of gallbladder cancer using contrast-enhanced ultrasonography

Abstract

A 49-year-old male was admitted with right upper quadrant pain. CT, US, and MRI showed abnormal thickening of gallbladder wall with multiple cystic components. The border between gallbladder wall and liver was unclear. We suspected xanthogranulomatous cholecystitis (XGC), but cannot deny gallbladder carcinoma with hepatic invasion. To confirm tentative diagnosis, we performed contrast-enhanced US (CE-US). In the early phase of the CE-US, the gallbladder wall was homogenously enhanced, and all the cystic components were in the thickened wall. And then, in the later phase of the CE-US, the border between gallbladder wall and liver became clear. On the basis of these examinations, we diagnosed as XGC, rather than gallbladder carcinoma with hepatic invasion. Open cholecystectomy was performed and histopathological diagnosis was XGC.