Abstract
A 68-year-old man was pointed out as having a thickened gallbladder wall by a family doctor and referred to our hospital. Abdominal ultrasonography revealed a segmental type of adenomyomatosis ot the gallbladder and multiple papillary lesions in its neck side lumen. The mucosa of the fundus side was smooth. Abnormal arrangement of the pancreato-biliary ductal system (AAPB) was not shown in MRCP. We conducted cholecystectomy based on the preoperative diagnosis of adenoma or early cancer of the gallbladder. Bile juice amylase level in the gallbladder was very high, which suggested the existence of occult pancreato-biliary reflux (OPBR). Histopathologic examination revealed mucosal carcinoma in situ in the fundus side lumen and hyperplasia in the neck side mucosa. This patient had two risk factors for gallbladder cancer, a segmental type of adenomyomatosis and OPBR, which led to mucosal cancer in the fundus side lumen and hyperplastic mucosa in the neck side lumen.
