Gallbladder glandular proliferation mimicking an adenocarcinoma – A case report

Abstract

This case report presents a 39-year-old woman with a history of abdominal discomfort, gastroesophageal reflux disease, and previous biliary colic. Radiological investigations suggested a suspicious infundibular lesion in the gallbladder, prompting further examinations including magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and PET/CT scan. Despite inconclusive findings, the patient underwent robot-assisted cholecystectomy, revealing a fistula between the gallbladder infundibulum, and the common bile duct. Histological examination revealed a complex conglomerate of non-neoplastic processes, including gastric heterotopia, pseudo-pyloric glandular proliferation, and traumatic neuroma-like neural proliferation within the gallbladder wall. Discussion highlights the developmental anomalies and reactive mechanisms potentially underlying these findings, suggesting a connection between gastric heterotopia, glandular proliferation, and neural proliferation. The presence of three different 'pathological entities' in the same case represents the uniqueness of our case report, and the type of growth that sometimes appears to simulate an infiltration is an important element to consider as its misdiagnosis could lead to erroneous considerations and incorrect treatment.