ArticleCase reports in surgery2026
The Challenging Management of Gallbladder Masses: A Case of Xanthogranulomatous Cholecystitis and Diffuse Biliary Hamartomatosis Mimicking Gallbladder Metastatic Cancer.
Article in Case reports in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
Background: Xanthogranulomatous cholecystitis (XGC) is a rare form of chronic cholecystitis characterized by progressive fibrosis of the gallbladder wall. Its clinical, laboratory, and radiological features often mimic gallbladder carcinoma (GC), making preoperative diagnosis challenging. A definitive diagnosis is usually established by histopathological examination. As XGC may occasionally coexist with malignancy, surgical resection is generally recommended. Case Presentation: A 66-year-old woman presented with weight loss, epigastric discomfort, and a palpable mass in the right upper quadrant. Imaging revealed diffuse gallbladder wall thickening and a 33-mm vascularized mass in the gallbladder fundus, with suspected extension to the liver, transverse colon, and abdominal wall, strongly suggesting GC. Multiple hepatic cysts were also identified. Following multidisciplinary evaluation, laparoscopic exploration was performed. Hepatic and colonic infiltration, distortion of Calot's triangle, regional lymphadenopathy, and diffuse millimetric liver lesions initially suggested GC with intrahepatic metastases. However, histological examination of biopsied lesions excluded malignancy. After a 4-month recovery from COVID-19, the patient experienced clinical improvement and weight gain. Follow-up computed tomography (CT) showed regression of both the gallbladder mass and hepatic involvement, supporting a benign inflammatory process. During subsequent laparotomy, frozen-section analysis of the colonic infiltration confirmed inflammatory tissue. Radical cholecystectomy with en bloc resection of the adjacent liver parenchyma was performed. Final histopathology revealed diffuse XGC associated with diffuse biliary hamartomatosis. Conclusion: This case highlights the diagnostic challenge of distinguishing XGC from GC, particularly in the presence of biliary hamartomatosis. A stepwise diagnostic approach and multidisciplinary decision-making were essential to ensure accurate diagnosis and appropriate management.
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