Case Report
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World J Gastroenterol. Apr 14, 2006; 12(14): 2293-2296
Published online Apr 14, 2006. doi: 10.3748/wjg.v12.i14.2293
Extended surgical resection for xanthogranulomatous cholecystitis mimicking advanced gallbladder carcinoma: A case report and review of literature
Antonino Spinelli, Guido Schumacher, Andreas Pascher, Enrique Lopez-Hanninen, Hussain Al-Abadi, Christoph Benckert, Igor M Sauer, Johann Pratschke, Ulf P Neumann, Sven Jonas, Jan M Langrehr, Peter Neuhaus
Antonino Spinelli, Guido Schumacher, Andreas Pascher, Hussain Al-Abadi, Christoph Benckert, Igor M Sauer, Johann Pratschke, Ulf P Neumann, Sven Jonas, Jan M Langrehr, Peter Neuhaus, Department of General, Visceral and Transplantation Surgery, Charitè-Universitatsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
Enrique Lopez-Hanninen, Department of Radiology, Charitè-Universitatsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
Correspondence to: Antonino Spinelli, MD, Department of Ge-neral, Visceral and Transplantation Surgery, Charitè-Universitatsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany. antoninospinelli@email.it
Telephone: +49-30-450552001 Fax: +49-30-450552900
Received: September 2, 2005
Revised: May 1, 2005
Accepted: November 18, 2005
Published online: April 14, 2006
Abstract

Xanthogranulomatous cholecystitis (XGC) is a destructive inflammatory disease of the gallbladder, rarely involving adjacent organs and mimicking an advanced gallbladder carcinoma. The diagnosis is usually possible only after pathological examination. A 46 year-old woman was referred to our center for suspected gallbladder cancer involving the liver hilum, right liver lobe, right colonic flexure, and duodenum. Brushing cytology obtained by endoscopic retrograde cholangiography (ERC) showed high-grade dysplasia. The patient underwent an en-bloc resection of the mass, consisting of right lobectomy, right hemicolectomy, and a partial duodenal resection. Pathological examination unexpectedly revealed an XGC.

Only six cases of extended surgical resections for XGC with direct involvement of adjacent organs have been reported so far. In these cases, given the possible coexistence of XGC with carcinoma, malignancy cannot be excluded, even after cytology and intraoperative frozen section investigation. In conclusion, due to the poor prognosis of gallbladder carcinoma on one side and possible complications deriving from highly aggressive inflammatory invasion of surrounding organs on the other side, it seems these cases should be treated as malignant tumors until proven otherwise. Clinicians should include XGC among the possible differential diagnoses of masses in liver hilum.

Keywords: Xanthogranulomatous cholecystitis; Gallbladder cancer; Gallbladder carcinoma