A case of mucinous cystic neoplasm of the gallbladder

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.

A Rare Case: Primary Mucinous Cystic Neoplasm of the Gallbladder

“…Patients may be asymptomatic or obstructive jaundice, abdominal pain, palpable mass, nausea and vomiting may occur. Lesions originating from the cystic duct generally lead to obstructive symptoms (5).The size of the cyst may vary from small to giant cysts reaching 30 cm in size (7). In the presented case, the cyst size was 1 cm in diameter and the cyst was asymptomatic.…”

A Rare Case: Primary Mucinous Cystic Neoplasm of the Gallbladder

“…MCN of the liver and biliary system principally occur in the liver, followed by the extrahepatic biliary system (5). Only a few case reports have been reported primarily in the gallbladder.…”

Obstructive Jaundice Caused by Mucinous Cystic Tumor of Gallbladder: A Case Report and Literature Review

“…There are others who classify MCN using three subtypes, based on epithelial atypia and infiltration; the subtypes are mucinous cyst-adenoma, non-invasive mucinous cystadenocarcinoma, and invasive mucinous cystadenocarcinoma. 2 …”

“…The cystic duct mucinous cystic tumor is a rare cystic duct tumor with latent malignant lesions, and represents a special pathological type in cholangiocarcinoma. 1 , 2 Mucinous cystic tumors of the cystic duct are divided into mucinous cystadenoma and mucinous cystadenocarcinoma. 3 Currently, cystadenoma is generally considered to be a precancerous lesion of cystadenocarcinoma, so patients in whom this disease is suspected should be decisively operated, with their intraoperative fast frozen sections used to guide the operation.…”

“…3 Currently, cystadenoma is generally considered to be a precancerous lesion of cystadenocarcinoma, so patients in whom this disease is suspected should be decisively operated, with their intraoperative fast frozen sections used to guide the operation. 2 , 3 The etiology of mucinous cystic gland tumors of the bile ducts is currently unclear. Some believe that this is a congenital disease, caused by fluid retention as a result of inflammatory hyperplasia or obstruction of some abnormal ducts that occurs during embryonic growth; others believe that mucinous cystic tumors of the cystic duct are related to preembryonic intestinal residual or ectopic ovarian tissue.…”