J Korean Soc Radiol.  2018 Nov;79(5):290-293. 10.3348/jksr.2018.79.5.290.

Localized Adenomyomatosis of Gallbladder Mimicking Advanced Hepatic Flexure Colon Cancer: A Case Report

• Suh PS
• Kim B
• Lee D
• Lee KM
• Lee JH
• Kim HJ
• Kim JK

• KMID: 2422908
• DOI: http://doi.org/10.3348/jksr.2018.79.5.290

Abstract

Localized forms of gallbladder adenomyomatosis are rarely polypoid and may mimic gallbladder cancer. Herein, we present a unique case of polypoid gallbladder adenomyomatosis penetrating the colon and preoperatively misdiagnosed as advanced hepatic flexure colon cancer.

MeSH Terms

Adenomyoma
Colon*
Colonic Neoplasms*
Gallbladder Neoplasms
Gallbladder*

Figure

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  Fig. 1 Localized adenomyomatosis of gallbladder in 62-year-old female patient initially misdiagnosed as an advanced hepatic flexure colon cancer. A. The colonoscopy shows a 3 cm polypoid mass with ulceration, mucosal denudation in the stalk, and the mucosa of the mass is different from the colonic mucosa. B. Axial image of contrast enhanced CT scan depicts a heterogeneous enhancing intraluminal polypoid mass in the hepatic flexure of the colon (arrow), with extension to the adjacent gallbladder fundus (arrowhead). On coronal image, this mass is closely abutting the adjacent liver parenchyma, causing tethered appearance of the liver surface (arrow). Colon cancer with gallbladder and liver invasion was highly suspected. C. Gross specimen shows brownish polypoid mass arising from the gallbladder, same color as gallbladder mucosa. D. Photomicrograph reveals the mass composed of gallbladder mucosa (arrowhead), connected to the atrophied colonic mucosa (arrow). Rokitansky-Aschoff sinuses are located in the hypertrophied muscular layer, suggesting adenomyomatous hyperplasia (hematoxylin and eosin stain, × 40).

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