Malignant gallbladder polyp – diagnostic challenges in complicated acute cholecystitis: a clinical case and literature review

Abstract

Introduction: Gallbladder polyps are relatively rare. Those that undergo malignant transformation require timely and precise laboratory and imaging diagnostics. Case report: This article presents a case of a 73-year-old woman with evidence of acute cholecystitis and cholangitis on the background of an established gallbladder polyp. The results of laboratory tests, ultrasonography, magnetic resonance imaging, contrast-enhanced abdominal computed tomography and endoscopic retrograde cholangiopancreatography could not exclude malignant transformation of the polyp. After laparoscopic cholecystectomy, a moderately differentiated gallbladder tumor with pathological characteristics pT2a L0 V0 Pn0 G2 R0, according to the current TNM classification, was histologically diagnosed. The patient was additionally scheduled for lymphatic dissection. Discussion and conclusion: Although neoplastic gallbladder polyps are benign, they represent a precancerous condition that places the patient at risk of developing cancer with a poor prognosis. Therefore, suspicious data for malignancy require a wider range of laboratory and imaging studies, both to confirm the diagnosis and to assess the extent of the cancer process in order to select the optimal therapeutic approach.