A case of gallbladder carcinoma arising in adenomyomatosis of the gallbladder with high confluence of pancreaticobiliary ducts

Abstract

The patient was a 67-year-old woman. The patient was referred to our department because a gallbladder mass was noted on abdominal ultrasonography. Imaging studies suggested gallbladder cancer associated with segmental adenomyomatosis and gallbladder carcinoma at fundus of the gallbladder. ERCP performed for cytological diagnosis showed a high confluence of pancreaticobiliary ducts, and bile amylase was high at 49,800IU/L. The patient was diagnosed as gallbladder cancer arising from adenomyomatosis with high confluence of pancreaticobiliary ducts, and underwent laparoscopic cholecystectomy. The pathological diagnosis was papillary gallbladder carcinoma associated with segmental adenomyomatosis and flattened gallbladder carcinoma at fundus, and additional hepatic resection was performed. Segmental adenomyomatosis is considered to have a high risk of gallbladder cancer complication at fundus. When there is pancreatic reflux due to high confluence of pancreaticobiliary ducts (including pancreaticobiliary maljunction), diagnosis and treatment should be performed with the possibility of cancer complication at the adenomyomatosis.