Mycobacterial Infection of the Gallbladder Masquerading as Gallbladder Cancer with a False Positive Pet Scan

Abstract

Isolated mycobacterial infection of gall bladder is an extremely rare entity. Only anecdotal reports are evident in the literature. A preoperative diagnosis of mycobacterial infection of gallbladder is therefore very difficult. The case of a 72-year-old male who underwent surgery for suspected gallbladder cancer is presented. The diagnosis of cancer was based on radiological findings and an abnormal uptake of fluorine-18-fluoro-2-deoxy-D-glucose (FDG) on positron emission tomography (PET) scan whilst being followed up for colorectal cancer. He underwent cholecystectomy and gallbladder bed resection. Histopathology was consistent with mycobacterial infection of the gallbladder.

Staging Laparoscopy Is Not the Best Option to Identify Unresectable Gallbladder Cancer With 100% of Accuracy

“…Tuberculosis is known to masquerade GBC and can give a false-positive PET result. 6 In addition, a PET scan is also not very accurate in determining the locoregional resectability of GBC. As regard to the reference from the article by Ruys et al, 7 stating "After PET-CT examination, the yield of SL in biliary cancer would be drastically decreased, with value less than 5%," the authors themselves acknowledge that patients with GBC do have a high likelihood of metastatic disease and therefore the inclusion of this subset of patients has a considerable impact on the number of metastases found by SL.…”