Unusual cause of abdominal pain in a young adult: The clinical pitfalls of adenocarcinoma of the gallbladder with liver invasion

Abstract

Gallbladder (GB) cancer is a rare cause of abdominal pain in young adults. It is difficult to confirm an immediate and correct diagnosis based on the presentation of an acute episode of abdominal pain. We report a 36-year-old man who was referred to our hospital because of right upper abdominal pain that had persisted for 1 month. The tentative diagnosis was gallstone-induced acute on chronic cholecystitis according to the clinical symptoms/signs and imaging studies. Laparoscopic cholecystectomy (LC) was performed after admission. Histological examination revealed adenocarcinoma of the GB that was moderately differentiated and invading the perimuscular connective tissue. Magnetic resonance imaging was performed after the surgery, showing negativity for the invasion to other organs. Laparoscopic bisegmentectomy of the liver (seg. 4b + 5) and lymph node dissection was performed following LC. Adjuvant chemotherapy was administered, and the patient is currently alive without recurrence for 6 months. The uncommon etiology of cholecystitis in young adults is discussed.

Keywords

• gallstone
• murphy's sign
• adenocarcinoma
• cholecystitis