Giant Gallbladder Tumor, Unusual Cancer-Case Report and Short Review of Literature.

cholecystectomy gallbladder cancer giant gallbladder intracholecystic papillary–tubular neoplasm

Journal

Diagnostics (Basel, Switzerland)
ISSN: 2075-4418
Titre abrégé: Diagnostics (Basel)
Pays: Switzerland
ID NLM: 101658402

Informations de publication

Date de publication:
05 Jan 2023
Historique:
received: 13 12 2022
revised: 30 12 2022
accepted: 31 12 2022
entrez: 21 1 2023
pubmed: 22 1 2023
medline: 22 1 2023
Statut: epublish

Résumé

Giant gallbladder is an uncommon condition that can result from a benign pathology and rarely presents with malignancy. Intracholecystic papillary-tubular neoplasm (ICPN) is a relatively new entity first described by V. Adsay in 2012 and included in the World Health Classification of Digestive System Tumours in 2019. Intracholecystic papillary-tubular neoplasm is a preinvasive lesion with an incidence of around 1% that may present as four histologic subtypes-biliary, gastric, intestinal, or oncocytic-of which the biliary subtype has the highest risk of associated invasive cancer. Although invasive carcinoma is present in about 50% of cases of ICPN, these patients have a significantly better prognosis than those with usual gallbladder cancer, suggesting that the entities may have distinct biological signatures. A 77-year-old female presented to the hospital with progressive swelling in the right hemiabdomen, a loss of appetite, and weight loss. MRI highlighted a giant abdominal tumor located in the right hypochondrium and right abdominal flank with liver invasion (segment V). Preoperatively, a gallbladder 25 × 17 cm in size was noted, and the patient underwent radical cholecystectomy. It was surprising to find such a giant malignant gallbladder tumor, diagnosed as invasive poorly cohesive carcinoma associated with ICPN. A megacholecyst is a rare discovery. Although most often found in benign pathologies, giant gallbladder cancer can be considered. The neoplastic features and the loco-regional extension of the tumor must be evaluated by imaging scans. Few cases of giant benign gallbladder have been reported in the literature; however, this appeared to be the largest resectable gallbladder carcinoma reported to date according to the literature. The stage of gallbladder neoplasia is not correlated with the size of the gallbladder. Regardless of tumor size, the prognosis seems to be directly related to the stage, morphology, and resectability.

Sections du résumé

BACKGROUND BACKGROUND
Giant gallbladder is an uncommon condition that can result from a benign pathology and rarely presents with malignancy. Intracholecystic papillary-tubular neoplasm (ICPN) is a relatively new entity first described by V. Adsay in 2012 and included in the World Health Classification of Digestive System Tumours in 2019. Intracholecystic papillary-tubular neoplasm is a preinvasive lesion with an incidence of around 1% that may present as four histologic subtypes-biliary, gastric, intestinal, or oncocytic-of which the biliary subtype has the highest risk of associated invasive cancer. Although invasive carcinoma is present in about 50% of cases of ICPN, these patients have a significantly better prognosis than those with usual gallbladder cancer, suggesting that the entities may have distinct biological signatures.
CASE REPORT METHODS
A 77-year-old female presented to the hospital with progressive swelling in the right hemiabdomen, a loss of appetite, and weight loss. MRI highlighted a giant abdominal tumor located in the right hypochondrium and right abdominal flank with liver invasion (segment V). Preoperatively, a gallbladder 25 × 17 cm in size was noted, and the patient underwent radical cholecystectomy. It was surprising to find such a giant malignant gallbladder tumor, diagnosed as invasive poorly cohesive carcinoma associated with ICPN.
DISCUSSION CONCLUSIONS
A megacholecyst is a rare discovery. Although most often found in benign pathologies, giant gallbladder cancer can be considered. The neoplastic features and the loco-regional extension of the tumor must be evaluated by imaging scans. Few cases of giant benign gallbladder have been reported in the literature; however, this appeared to be the largest resectable gallbladder carcinoma reported to date according to the literature.
CONCLUSION CONCLUSIONS
The stage of gallbladder neoplasia is not correlated with the size of the gallbladder. Regardless of tumor size, the prognosis seems to be directly related to the stage, morphology, and resectability.

Identifiants

pubmed: 36673003
pii: diagnostics13020194
doi: 10.3390/diagnostics13020194
pmc: PMC9857600
pii:
doi:

Types de publication

Case Reports

Langues

eng

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Auteurs

Adrian Constantin (A)

Department of Esophageal and General Surgery, "Saint Mary" Clinical Hospital Bucharest, 011192 Bucharest, Romania.
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 050474 Bucharest, Romania.

Florin Achim (F)

Department of Esophageal and General Surgery, "Saint Mary" Clinical Hospital Bucharest, 011192 Bucharest, Romania.
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 050474 Bucharest, Romania.

Tudor Turcu (T)

Department of Pathology, University Emergency Hospital Bucharest, 050098 Bucharest, Romania.
Pathoteam Diagnostic Bucharest Pathology Laboratory, 051923 Bucharest, Romania.

Adelina Birceanu (A)

Pathoteam Diagnostic Bucharest Pathology Laboratory, 051923 Bucharest, Romania.
Department of Pathology, "Saint Mary" Clinical Hospital Bucharest, 011192 Bucharest, Romania.

Anca Evsei (A)

Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 050474 Bucharest, Romania.
Pathoteam Diagnostic Bucharest Pathology Laboratory, 051923 Bucharest, Romania.
Department of Pathology, "Saint Mary" Clinical Hospital Bucharest, 011192 Bucharest, Romania.

Bogdan Socea (B)

Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 050474 Bucharest, Romania.
Department of Surgery, Sf. Pantelimon Emergency Clinical Hospital, 021659 Bucharest, Romania.

Dragos Predescu (D)

Department of Esophageal and General Surgery, "Saint Mary" Clinical Hospital Bucharest, 011192 Bucharest, Romania.
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 050474 Bucharest, Romania.

Classifications MeSH