A rare lesion of the gallbladder: pyloric gland adenoma

Abstract

Gallbladder adenomas are rare, but well-documented benign epithelial tumors. They are usually found incidentally in cholecystectomy specimens or during preoperative imaging studies. Although they are usually asymptomatic, they may present as a result of associated symptomatic gallstones, or from cystic duct obstruction due to large adenoma. Three subtypes of adenoma are defined: tubular, papillary and tubulopapillary and they are further classified histopathologically as pyloric gland, intestinal and biliary types. Most adenomas found in the gallbladder are pyloric gland type. A 52-year-old woman suffering from aspecific upper abdominal pain was admitted in the surgery department of our hospital. Physical examination did not reveal any abnormalities nor did routine blood testing. Abdominal ultrasonography showed a polypoid lesion in the gallbladder measuring 1.5cm long. Laparoscopy was performed showing normal anatomy of the gallbladder and surroundings. The gallbladder as well as the Mascagni lymph node were removed. Macroscopic examination of the gallbladder revealed a polypoid lesion in the gallbladder body measuring 1.5cm in diameter (A). On microscopy, the polypoid lesion was almost entirely made up of tightly packed pyloric type tubular glands with little intervening stroma (B). In the background gallbladder epithelium there were no abnormalities. Recovery after surgery was uneventful and the symptoms did not recur.

Keywords

• gallbladder
• adenoma
• surgery