Xanthogranulomatous cholecystitis: The great gallbladder carcinoma masquerader

Introduction: Xanthogranulomatous chole-cystitis represents an uncommon chronic cholecystitis characterized by gallbladder wall thickening infiltrating to the adjacent liver parenchyma. This feature creates a challenge for the hepatobiliary surgeon in treating this rare disease, which mimics gallbladder carcinoma leading to unnecessary enlarged hepatic resection. Case Report: A 62-year-old male presenting at emergency department complaining of eight weeks history of right upper quadrant pain, nausea, with intermittent vomiting and severe weight loss. Surgical consultation was obtained. All imaging workup, including conventional abdominal ultrasound, computed tomography scan of the abdomen and pelvis, magnetic resonance imaging scan of the abdomen and positron emission tomography scan suggested gallbladder carcinoma. He underwent extended right hepatectomy, pancreaticoduodenectomy, with primary intrahepatic Roux-Y hepaticojejunostomy. The hospital course of patient was unremark-able being discharged six days after surgery. Final pathology was compatible with xanthogranulomatous cholecystitis. Conclusion: This rare entity can lead the hepatobiliary surgeon to face a challenge and sometime useless surgical treatment which might provoke morbidity and mortality to the patient. More define clinical and radiographic criteria are needed in diagnosing and treating xanthogranulomatous cholecystitis, which must be labeled as the great gallbladder carcinoma masquerader. (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 8 No. 3, March 2017. ISSN – [0976-3198] Int J Case Rep Images 2017;8(3):222–226. www.ijcasereportsandimages.com Arcerito et al. 222 CASE IN IMAGES PEER REVIEWED | OPEN ACCESS Xanthogranulomatous cholecystitis: The great gallbladder carcinoma masquerader Massimo Arcerito, John Moon, Kevin Tri Nguyen