Combined Fundal and Segmental Adenomyomatosis of the Gallbladder in a Child: A Rare Case Report

Abstract

Adenomyomatosis of the gallbladder (AMG) is characterized by mucosal hyperplasia leading to invagination through the thickened muscle layer, which is relatively common in adults, but is rare in childhood. We report a 12-year-old boy with adenomyomatosis of the gallbladder combined segmental and fundal type. This combined type is rare in adults and is first reported here in childhood. Although initial imaging with computed tomography (CT) suggested the presence of a circular solid mass-like lesion because of its rare morphology, repeated ultrasonography (US) was useful for leading to a correct diagnosis.

Adenomyomatosis of the Gallbladder as a Cause of Abdominal Pain in Pediatrics: A Case Report of an Adolescent and a Literature Review

“…To our knowledge, only 14 cases (including ours) of adenomymatosis of the gallbladder have been described in the pediatric age group since 1998 (Table 1 ) ( 1 , 8 – 19 ). The age at presentation varied between few weeks of age to 17 years, and there was no gender discrimination.…”

“…Gallbladder adenomyomatosis (GA) is a benign condition, which is characterized by mucosal hyperplasia of gallbladder and formation of intramucosal invagination through the thickened mucosal layer which is known as the Rokitansky Aschoff sinuses (RAS) ( 1 ). Adenomyomatosis, also known as adenomyoma or adenomyomatous hyperplasia of the gallbladder, is one of the two hyperplastic cholecystoses.…”

Diffuse Gallbladder Adenomyomatosis with an Inflammatory Complication in an Adult

“…3 ). Three types of GA are described: fundal (localized), segmental (annular), and more rarely diffuse (generalized) [ 6 ]. The fundal pattern localizes at the fundus of the gallbladder, which presents as a central dimple.…”

“…The diffuse pattern is extremely rare and manifests with thickening of the entire gallbladder wall (Fig. 4 ) [ 4 , 5 , 6 , 7 ].…”

“…Pearl necklace sign, which reveals the presence of Rokitansky-Aschoff sinuses, is a specific finding of GA at magnetic resonance cholangiopancreatography [ 3 , 7 , 8 ]. The differential diagnosis includes all diseases that cause gallbladder wall thickening, such as xanthogranulomatous cholecystitis, chronic cholecystitis, or gallbladder cancer [ 5 , 6 , 7 , 8 , 9 ].…”