Gallbladder paraganglioma with hemorrhage: A case report and literature review

Abstract

Gallbladder paraganglioma (GP) is a rare tumor, with only 12 cases reported in the literature to date. Due to its rarity, clinical information of GP is insufficient. We present a case of GP in a 48-year-old female along with a literature review of all GP cases described to date. A 48-year-old female presented with intermittent right upper abdominal pain. Preoperative imaging revealed a hematoma in the gallbladder lumen without any definite etiology. Laparoscopic cholecystectomy was performed. Gross examination of the gallbladder revealed multiple small stones and a large hematoma as well as a 1.6-cm-sized polypoid mass at the gallbladder fundus. Microscopic study of the polypoid mass showed a zellballen appearance. Immunohistochemical analysis revealed that the mass was positive for synaptophysin, CD56, and chromogranin, suggesting GP. GP is difficult to diagnose because of non-specific clinical findings. Almost all GP cases are diagnosed based on histologic findings after cholecystectomy. Simple cholecystectomy was performed as a treatment in all reported cases of GP, including our case. There was no postoperative tumor recurrence or metastasis after surgery.

Gallbladder Paraganglioma: A Mysterious Histological Finding

“…On review of the literature, there are no reports of complicated postoperative recovery. The authors of a case report of hemorrhagic gallbladder paraganglioma repeated abdominal CT at six weeks postoperatively, which did not show any evidence of tumor recurrence or any significant findings; however, they did not comment on whether the CT was performed to ensure that there was no further hemorrhage or for surveillance for paraganglioma [ 18 ]. Blood and urine catecholamine may be considered to look for metastatic or residual disease [ 3 ].…”

Gallbladder Paraganglioma- A Rare Case Report

“…It can occur in a variety of locations including the orbit, nose, ear, carotid area, vagus nerve, larynx, mediastinum, retroperitoneum, organ of Zuckerkandl, urinary bladder, cauda equina, duodenum, prostate, cheek and thyroid. 2 Primary gallbladder paraganglioma (GP) theoretically arise from primordia of hepatic plexus, which innervates the gallbladder and are formed from sympathetic and parasympathetic fibers of the left vagus nerve and celiac plexus. 3 Paragangliomas are very rare in the gallbladder.…”

“…Only 13 cases of GP have been reported in the literature so far. [1][2][3][4][5][6][7][8][9][10][11] We aimed to present a non-functional gallbladder paraganglioma.…”