Advertisement

A case of mucinous cystic neoplasm of the gallbladder

  • Shuichiro Sugawara
  • Ichiro Hirai
  • Toshihiro Watanabe
  • Koji Tezuka
  • Wataru Kimura
Case Report
  • 131 Downloads

Abstract

The patient was a 70-year-old woman in whom examination revealed a high level of carbohydrate antigen 19-9. Abdominal ultrasonography and computed tomography (CT) revealed a multilocular cystic lesion compressing the gallbladder. CT indicated the presence of a multilocular cystic tumor (67 × 68 × 72 mm) in contact with the right hepatic lobe. Intraoperative findings indicated that the cyst diameter was 8.5 × 6.0 cm, and the cyst was continuous with the gallbladder. The gallbladder was resected along with the cyst. The cyst was multilocular and originated from the cystic duct and gallbladder wall. The cyst wall contained cuboidal to columnar mucin-producing epithelial cells and ovarian-like stroma (OS). The final diagnosis was mucinous cystic neoplasm (MCN) of the gallbladder with low-grade dysplasia. In the 2010 WHO classification of tumors of the digestive system, MCN have been newly defined as a type of hepatobiliary tract epithelial neoplasms. MCN of the gallbladder with OS is extremely rare. Only three cases have been published in the literature. The presence of OS is necessary for diagnosis of MCN.

Keywords

Mucinous cystic neoplasm Gallbladder Ovarian-like stroma 

Notes

Compliance with ethical standards

Conflict of interest

Shuichiro Sugawara, Ichiro Hirai, Toshihiro Watanabe, Koji Tezuka, and Wataru Kimura declare that they have no conflict of interest.

Human rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all patients for being included in the study.

References

  1. 1.
    Nakanuma Y, Curabo MP, Franceschi S, et al. Intrahepatic cholangiocarcinoma. In: Bosman FT, Carneiro F, Hruban RH, et al., editors. WHO classification of tumours of the digestive system; World Health Organization of Tumours. 4th ed. Lyon: IARC; 2010. p. 217–24.Google Scholar
  2. 2.
    Albores-Saavedra J, Adsay NV, Crawford JM, et al. Carcinoma of the gallbladder and extrahepatic bile ducts. In: Bosman FT, Carneiro F, Hruban RH, et al., editors. WHO classification of Tumours of the digestive system; World Health Organization of Tumours. 4th ed. Lyon: IARC; 2010. p. 266–73.Google Scholar
  3. 3.
    Spector SA, Fernandez VE, Vernon SE, et al. Gallbladder cystadenoma and common bile duct obstruction. Int J Gastrointest Cancer. 2003;34:151–5.CrossRefPubMedGoogle Scholar
  4. 4.
    Zevallos QJC, Jiménez AR, Garmendi IM, et al. Mucinous cystic neoplasm of the gallbladder obstructing the common bile duct, a rare entity with a new name. Cir Esp. 2014;92:567–9.CrossRefGoogle Scholar
  5. 5.
    Compagno J, Oertel JE. Mucinous systic neoplasms of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma). A clinicopathologic study of 41 cases. AM J Clin Pathol. 1978;69:573–80.CrossRefPubMedGoogle Scholar
  6. 6.
    Yamao K, Yanagisawa A, Takahashi K, et al. Clinicopathological features and prognosis of mucinous cystic neoplasm with ovarian-type stroma: a multi-institutional study of the Japan Pancreas Society. Pancreas. 2011;40:67–71.CrossRefPubMedGoogle Scholar
  7. 7.
    Simmons TC, Miller C, Pesigan AM, et al. Cystadenoma of the gallbladder. Am J Gastroenterol. 1989;84:1427–30.PubMedGoogle Scholar
  8. 8.
    Devaney K, Goodman ZD, Ishak KG. Hepatobiliary cystadenoma and cystadenocarcinoma: a light microscopic and immunohistochemical study of 70 patients. Am J Surg Pathol. 1994;18:1078–91.CrossRefPubMedGoogle Scholar
  9. 9.
    Terada T, Takeuchi T, Taniguchi M. Hepatobiliary cystoadenocarcinoma with cystadenoma elements of the gallbladder in an old man. Pathol Int. 2003;53:790–5.CrossRefPubMedGoogle Scholar
  10. 10.
    Rooney TB, Schofer JM, Stanley MD, et al. Biliary cystadenoma of the gallbladder. AJR Am J Roentgenol. 2005;185:1571–2.CrossRefPubMedGoogle Scholar
  11. 11.
    Waldmann J, Zielke A, Moll R, et al. Cystadenocarcinoma of the gallbladder. J Hepatobiliary Pancreat Surg. 2006;13:594–9.CrossRefPubMedGoogle Scholar
  12. 12.
    McCague A, Rosen M, O’Malley K. Laparoscopic cholecystectomy of a polypoid gallbladder cystadenoma obstructing the common bile duct. Surg Laparosc Endosc Percutan Tech. 2008;18:209–12.CrossRefPubMedGoogle Scholar
  13. 13.
    Sistla SC, Sankar G, Basu D, et al. Biliary cystadenocarcinoma of the gall bladder: a case report. J Med Case Rep. 2009;3:75.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Gokalp G, Dusak A, Topal NB, et al. Cystadenoma originating from the gallbladder. J Ultrasound Med. 2010;29:663–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Fukuo Kondo. Pathology of epithelial tumors of bile duct: diagnostic criteria and their problems. J Jpn Biliary Assoc. 2013;27:680–8.Google Scholar
  16. 16.
    Mano Y, Aishima S, Fujita N, et al. Cystic tumors of the liver: on the problems of diagnostic criteria. Pathol Res Pract. 2011;207:659–63.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.First Department of SurgeryYamagata University Graduate School of Medical ScienceYamagatashiJapan

Personalised recommendations