Mucinous Adenocarcinoma of Gallbladder Presenting As Acute Calculous Cholecystitis

Abstract

Mucinous adenocarcinoma (MAC) is a rare type of gallbladder cancer accounting for less than 5% of the reported cases. It is characterized by mucin deposition involving more than 50% of the tumor volume. It is a distinct subtype of gallbladder cancer and associated with poor prognosis. Accurate preoperative diagnosis is difficult. Most of the cases are diagnosed incidentally during the histopathological examination of the resected gallbladder. We report the case of a 75-year-old man who presented with right upper abdominal pain, fever, and vomiting for 15 days. Abdominal ultrasound revealed acute calculous cholecystitis for which he underwent laparoscopic cholecystectomy. Histological examination of the gallbladder found ulcerated gallbladder mucosa lined with dysplastic epithelium. The tumor was mainly composed of dysplastic glands floating in the pools of mucin with invasion of the perivascular connective tissue suggestive of MAC. This case highlights the importance of histological examination of gallbladder after routine cholecystectomy.

Mucinous Adenocarcinoma of Gallbladder: An Incidental Finding of Acute Cholecystitis With Cholelithiasis

“…Mucinous adenocarcinoma tumors contain more than 50% of mucin components and are clinically characterized by poor prognosis. Initial presentation can mimic acute cholecystitis or cholelithiasis and histological findings post-cholecystectomy are the main diagnostic criteria of mucinous adenocarcinoma of the gallbladder [2]. Incidental gallbladder cancer (IGBC) is typically early-stage cancer as opposed to non-incidental; therefore, early surgical management confers increased survival benefits [3].…”

Development and validation of prognostic nomograms in patients with gallbladder mucinous adenocarcinoma: A population-based study

“…Several studies have shown that mucinous adenocarcinoma of the colorectum has a poor prognosis ( 8 , 9 ), but in the breast mucinous adenocarcinoma has a better prognosis than invasive ductal carcinoma ( 10 ), and some studies have shown no significant difference in prognosis between patients with mucinous and non-mucinous cancers ( 11 , 12 ). Gallbladder mucinous adenocarcinoma (GBMAC) is one of the rarest subtypes of gallbladder cancer, accounting for less than 5% of case reports ( 13 ). There are very few studies on the clinical features and prognosis of GBMAC, which are limited to some case reports and small retrospective studies ( 14 – 16 ).…”