Gallbladder mucocele caused by intestinal metaplasia in lithiasic cholecystitis : A case report and literature review of a rare association
Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved..
INTRODUCTION: Mucin hypersecretion promoted by intestinal metaplasia can lead to gallstone formation. The presence of large amounts of mucin induced by a change in biliary epithelium structure is called a mucocele, a usually benign condition studied among animals but rarely described in humans. This entity must be distinguished from hydrops, a condition secondary to an impacted gallstone in the cystic duct leading to an outlet obstruction and distension of the gallbladder.
PRESENTATION OF CASE: We report a case of a 51-year-old female with lithiasic cholecystitis showing areas of intestinal metaplasia associated with a mucocele. Laparoscopic cholecystectomy was performed with an uneventful postoperative course. Macroscopic findings revealed a dilated gallbladder filled with mucoid fluid. Signs of chronic and focally acute cholecystitis with areas of intestinal metaplasia were observed microscopically.
DISCUSSION: Lithiasic gallbladders can bear a gene that is found in goblet cells of intestinal metaplasia, leading to mucin hypersecretion. Metaplasia - a benign lesion often encountered on cholecystectomy specimens - can be the precursor of carcinoma. Mucin-producing gallbladder carcinoma is a very aggressive tumor that can appear as a mucocele. Consequently, preoperative computed tomography or magnetic resonance cholangiopancreatography should be performed in the presence of an unusual aspect on sonography.
CONCLUSION: Metaplastic changes in gallbladder epithelium associated with an overproduction of mucin and lithiasic cholecystitis reported in this case is a rarity. Malignancy is an alternative diagnosis of gallbladder mucocele that must be suspected whenever preoperative imaging of the gallbladder is atypical.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:116 |
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| Enthalten in: |
International journal of surgery case reports - 116(2024) vom: 24. März, Seite 109405 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Poget, Marion [VerfasserIn] |
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| Links: |
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| Themen: |
Carcinoma |
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| Anmerkungen: |
Date Revised 18.03.2024 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.ijscr.2024.109405 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368926206 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a INTRODUCTION: Mucin hypersecretion promoted by intestinal metaplasia can lead to gallstone formation. The presence of large amounts of mucin induced by a change in biliary epithelium structure is called a mucocele, a usually benign condition studied among animals but rarely described in humans. This entity must be distinguished from hydrops, a condition secondary to an impacted gallstone in the cystic duct leading to an outlet obstruction and distension of the gallbladder | ||
| 520 | |a PRESENTATION OF CASE: We report a case of a 51-year-old female with lithiasic cholecystitis showing areas of intestinal metaplasia associated with a mucocele. Laparoscopic cholecystectomy was performed with an uneventful postoperative course. Macroscopic findings revealed a dilated gallbladder filled with mucoid fluid. Signs of chronic and focally acute cholecystitis with areas of intestinal metaplasia were observed microscopically | ||
| 520 | |a DISCUSSION: Lithiasic gallbladders can bear a gene that is found in goblet cells of intestinal metaplasia, leading to mucin hypersecretion. Metaplasia - a benign lesion often encountered on cholecystectomy specimens - can be the precursor of carcinoma. Mucin-producing gallbladder carcinoma is a very aggressive tumor that can appear as a mucocele. Consequently, preoperative computed tomography or magnetic resonance cholangiopancreatography should be performed in the presence of an unusual aspect on sonography | ||
| 520 | |a CONCLUSION: Metaplastic changes in gallbladder epithelium associated with an overproduction of mucin and lithiasic cholecystitis reported in this case is a rarity. Malignancy is an alternative diagnosis of gallbladder mucocele that must be suspected whenever preoperative imaging of the gallbladder is atypical | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Carcinoma | |
| 650 | 4 | |a Case report | |
| 650 | 4 | |a Cholecystitis | |
| 650 | 4 | |a Gallbladder mucocele | |
| 650 | 4 | |a Intestinal metaplasia | |
| 650 | 4 | |a Literature review | |
| 700 | 1 | |a Salvatori Chappuis, Vilma |e verfasserin |4 aut | |
| 700 | 1 | |a Carbó Descamps, Francesc |e verfasserin |4 aut | |
| 700 | 1 | |a Saadi, Alend |e verfasserin |4 aut | |
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