A Case of Early Cancer of Gallbladder Accompanied with Adenomyomatosis

Haruhiko Nagami, Katsuhiro Tamura*, Takahiko Nohara*, Tsuyoshi Yamamoto*, Masahisa Nakagawa*, Akira Nagase*

Department of Surgery, The Second Izumo City Hospital
*The First Department of Surgery, Shimane Medical University

We experienced a case of cholelithiasis with hourglass deformity of the gallbladder caused by adenomyomatosis accompanied by early gallbladder cancer. The patient, a 72-year-old woman, was diagnosed as having cholelithiasis with hourglass deformity of the gallbladder by endoscopic retrograde cholangiography and underwent cholecystectomy. An approximately 2.5 cm stone was found at the fundus of the surgically removed gallbladder, and histopathological examination of the specimen revealed chronic cholecystitis at the fundus of the gallbladder, segmental adenomyomatosis with proliferation of Rokitansky-Aschoff sinuses at the body of the gallbladder and an early cancer lesion in the gallbladder measuring 4.7 cm×4.0 cm (well-differentiated adenocarcinoma, m RAS ss) at the neck side of the gallbladder. In the Japanese literature, only six cases including our case of gallbladder cancer accompanied by adenomyomatosis have been reported to date. In the five cases other than ours, the cancer lesion was seen at the fundus side of the lesion of adenomyomatosis, while in our case, it was seen at the neck side of adenomyomatosis and it is speculated that this case leads to the theory that adenomyomatosis of the gallbladder may change into cancer.

Key words
adenomyomatosis, early gallbladder cancer, hourglass deformity of the gallbladder

Reprint requests
Haruhiko Nagami Department of Surgery, The Second Izumo City Hospital
238 Tiimiyachou, Izumo City, 693 JAPAN

Accepted
March 13, 1991

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