A Case of Hemorrhagic Gallbladder Paraganglioma Causing Acute Cholecystitis

Abstract

Gallbladder paraganglioma is a very rare tumor and so far only a few cases have been reported. Most of these were asymptomatic and were found incidentally during operation. Recently, we experienced a gallbladder paraganglioma that gave rise to hemorrhage, which in turn caused acute cholecystitis. Our case involved a 45 year-old female patient complaining of an intermittent right upper abdominal pain. After a preoperative evaluation, cholecystectomy and lymphadenectomy were performed under the impression of gallbladder cancer with acute cholecystitis. Postoperative pathologic examination revealed a hemorrhagic gallbladder paraganglioma accompanied by acute cholecystitis. Immunohistochemical staining of the chief cells for neuron specific enolase, chromogranin and synaptophysin were positive. Sustentacular cells also stained positively for S100 protein.

Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

“…The latter may be complicated by enterocolitis [98,99], volvulus or colonic rupture [100], and fecal peritonitis [101]. Other abdominal emergencies in patients who have pheochromocytoma include acute cholecystitis [102,103], acute pancreatitis [104], and ruptured aneurysm of the abdominal aorta [82].…”

A rare case of paraganglioma of the cystic duct

“…A literature review demonstrates nine cases of gallbladder paraganglioma [ 3 , [5] , [6] , [7] , [8] , [9] , [10] ], with the first reported case in 1972 by Miller at al [ 5 ], and three cases of hepatic paraganglioma [ [11] , [12] , [13] ], with the first reported case in 1980 by Sarma et al [ 11 ]. All reported paraganglioma cases were non-functional.…”

Intramural gallbladder hematoma mimicking gallbladder neoplasm in a 55-year-old male patient

“…It is very difficult to diagnose intramural gallbladder hematoma before surgery. It is almost impossible to diagnose, especially when the patient does not have trauma or hemophilia or is not onanticoagulant therapy [9,10]. …”