Abstract
An 85-year-old female was admitted as acute cholecystitis. After the inflammation composing, the ultrasonography showed multiple variable-sized elevated lesions in the gallbladder. The largest papillary tumor in the neck was 20 mm in diameter. The computed tomography showed mild enhancement of the gallbladder wall. Endoscopic retrograde cholangiopancreatography showed the irregular defects in the gallbladder. Endoscopic ultrasonography (EUS) showed the disorder of the 2 nd layer below the largest papillary tumor. The extended cholecystectomy with regional lymph nodes dissection was perfomed because of her age, complicated diseases, and intraoperative findings. The resected specimen revealed general wall thickning and irregular elevated lesions existed on the whole mucosa. The largest papillary tumor was crowded with rather big grain. Pathological examination revealed well differentiated adenocarcinomas within mucosal layer with superficial spread, except below the largest papillary tumor. Subserosal invasion was minimally detected accompanied by Rokitansky-Aschoff sinus carcinoma.
