Invasive Intracholecystic Papillary Neoplasm of Gall Bladder with Perforation: A Case Report

Abstract

Primary Gall Bladder (GB) carcinoma ranks globally as the sixth most common malignancy of gastrointestinal cancers and most common malignancy of biliary tract. Intracystic Papillary Neoplasm of GB (ICPN) is a subtype carcinoma of Intraductal Papillary Carcinoma of Bile duct (IPCB) and grows submucosally. Here the authors report a rare case of 58-years-old male patient, who came with the complaints of acute sharp pain in right upper quadrant and intermittent bilious vomiting. On examination, patient had right upper quadrant tenderness. He was diagnosed with moderately differentiated invasive ICPN of GB presenting as acute abdomen with right hypochondrial pain mimicking acute cholecystitis. On imaging, there was presence of gallbladder wall thickening with pericholecystic fluid collection suggestive of GB perforation. The patient also had incidental finding of congenital non rotation of gut. Intraoperatively, there was polypoidal lesion in GB with perforation of GB. Histopathology was reported as invasive ICPN and to the best of our knowledge, invasive ICPN presenting as acute abdomen with GB perforation is not reported in the literature.

Keywords

• cholecystitis
• computed tomography
• histopathology