Extremely rare case of H-type gallbladder duplication coexistent with carcinoma: a case report and review of the literature

Abstract

Introduction: Multiple gallbladders represent a rare congenital disorder, and coexistence with carcinoma is extremely rare, leading to a high possibility of misdiagnosis and surgical complications. In this study, a case was reported and the literature was reviewed. Case presentation: An 80-year-old woman was diagnosed with acute cholecystitis via ultrasonography and was successfully treated with antibiotics. After the patient's biliary colic relapsed, she was referred to our hospital. Multiple imaging modalities revealed duplication of her gallbladder (H-type) and suggested coexistence with carcinoma. According to preoperative evaluations, we assumed the patient had stage IIIA disease, and cholecystectomy, cholangiography using a near-infrared ray vision system, and sectionectomy of segments 4a and 5 were performed. Contrary to the high standardized uptake values obtained by 18 F-fluoro-2-deoxy-D-glucose positron emission tomography, gallbladder carcinoma was pathologically diagnosed as stage 0 mucosal cancer. Seven days after the operation, portal thrombosis of the posterior branch was revealed, and conservative therapy was indicated; satisfactory results were achieved. The patient was discharged 65 days after surgery. No recurrence was observed for 1 year after surgery. Conclusions: An extremely rare case of malignancy in a duplicated gallbladder was reported, and the literature was reviewed. Accurate estimations are feasible for diagnoses of multiple gallbladders, where correct evaluations are vital, especially in malignant cases. Because of the possibility of malignancy, resected accessory gallbladders should be scrutinized pathologically.

Successful Surgical Management of an Invasive Adenocarcinoma Within a Duplicated Gallbladder by an Extensive Hepatic Resection: A Case Report

“…A duplicated gallbladder can often appear similarly to a Todani II bile duct cyst on imaging, which is known to have an increased risk of malignancy [14]. Malignancy within duplicated gallbladders has been described in several case reports [3][4][5][6][7][8][9]. There are currently no formal guidelines for management of this extremely rare presentation.…”

“…This case report highlights the diagnosis and management of a suspicious mass identified within a duplicated gallbladder that was proven to be adenocarcinoma requiring a hepatic resection intraoperatively. To our knowledge, only six reported cases exist describing such a presentation in the literature with relative paucity of expert opinion on approaches to medical and surgical management [3][4][5][6][7][8][9].…”

Incidental adenocarcinoma of the gallbladder in a patient with Y insertion gallbladder duplication in the context of recurrent biliary colic

“…Mostly, both are benign and it is very rare to find adenocarcinoma in one of the GB in the case of duplication of GB. Only 5 reported cases of this coincidence have been identified in a recent literature review [2,5–8] …”

“…Only 5 reported cases of this coincidence have been identified in a recent literature review. [2,[5][6][7][8] We present a rare case of Adenocarcinoma which was found incidentally during laparoscopic cholecystectomy of a Y-insertion GB duplication.…”

Segnet Network Algorithm-Based Ultrasound Images in the Diagnosis of Gallbladder Stones Complicated with Gallbladder Carcinoma and the Relationship between P16 Expression with Gallbladder Carcinoma

“…The peak time (TTP), peak intensity (PI), contrast agent perfusion rate, and other related parameters are recorded to determine the benign and malignant tumors. It significantly improves the diagnostic coincidence rate [ 8 ].…”