2025 Volume 39 Issue 5 Pages 826-833
A 70-year-old woman underwent CT scan, which revealed the gallbladder wall thickening and cystic lesions in the pancreas. Abdominal MRI showed focal wall thickening of the gallbladder body, and segmental adenomyomatosis of the gallbladder was suspected. In addition, multiple cystic lesions were found in the pancreas, and pancreatic IPMN was suspected. When the MRI was repeated six months later, wall thickening of the gallbladder has enlarged and a mural nodule newly appeared in a cystic lesion of the pancreatic head. The diagnosis of gallbladder cancer and IPMC of the pancreas was made and pancreaticoduodenectomy with gallbladder bed resection was performed. Histopathological examination revealed that the gallbladder tumor was ductal adenocarcinoma with invasion to the sub serosa. The contents of the cystic lesion of the pancreatic head were black-greenish mucus. The inner layer of the cyst wall was also lined with adenocarcinoma cells. The cystic lesion on the retro-pancreatic head was diagnosed as cystic lymph node metastasis because it was located outside of the pancreas and its histology was similar to that of gallbladder carcinoma. There have been few reports of gallbladder cancer with cystic lymph node metastasis, and we did not find any reports in which changes could be observed with a long time.
