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Gall Bladder Papillary Carcinoma Presenting as Cholecystocolic Fistula and Metastasizing to Pericholecystic Lymph Node: an Incidental and Rare Finding—a Case Report

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Abstract

Gallbladder papillary carcinoma is a less common form of gallbladder carcinoma that accounts for around 5% of all gallbladder malignancies. Because of its early manifestation and delayed invasion in the gallbladder wall, it has a better prognosis than adenocarcinoma. It is quite rare for it to manifest as cholecystocolic fistula. Imaging aids in the diagnosis of the lesion and associated fistula, as well as in determining the surgical extent of excision. Histology further aids in accurate diagnosis by recognizing the papillary architecture of the tumor as well as the extent of invasion. We herein present a case of a 51-year-old female who presented with symptoms of abdominal pain and vomiting for a month. Contrast-enhanced computed tomography showed thickened gallbladder wall with the presence of cholecystocolic fistula and enlarged pericholecystic lymph node. Cholecystectomy with excision of fistulous tract and lymph node was done, which showed gallbladder papillary carcinoma with metastasis to lymph node. After surgery, the patient received chemotherapy and was followed for 2 years with no symptoms of recurrence. To summarize, papillary gallbladder cancer is less prevalent and has a better prognosis than adenocarcinoma. Imaging and histology are critical in identifying the lesion and determining the best treatment option.

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References

  1. Henson DE, Albores-Saavedra J, Corle D. Carcinoma of the GB Histologic types, stage of disease, grade, and survival rates. Cancer. 1992;70(6):1493–7.

    Article  CAS  PubMed  Google Scholar 

  2. Lazcano-Ponce EC, Miquel JF, Muñoz N, Herrero R, Ferrecio C, Wistuba II, Alonso de Ruiz P, AristiUrista G, Nervi F. Epidemiology and molecular pathology of GB cancer. CA Cancer J Clin. 2001;51(6):349–64.

    Article  CAS  PubMed  Google Scholar 

  3. Goldin RD, Roa JC. GB cancer: a morphological and molecular update. Histopathology. 2009;55(2):218–29.

    Article  PubMed  Google Scholar 

  4. Albores-Saavedra J, Tuck M, McLaren BK, Carrick KS, Henson DE. Papillary carcinomas of the GB: analysis of noninvasive and invasive types. Arch Pathol Lab Med. 2005;129(7):905–9.

    Article  PubMed  Google Scholar 

  5. Wang SJ, Fuller CD, Kim JS, Sittig DF, Thomas CR Jr, Ravdin PM. Prediction model for estimating the survival benefit of adjuvant radiotherapy for GB cancer. J Clin Oncol. 2008;26(13):2112–7.

    Article  PubMed  Google Scholar 

  6. Lee SS, Kim MH, Lee SK, Jang SJ, Song MH, Kim KP, Kim HJ, Seo DW, Song DE, Yu E, Lee SG, Min YI. Clinicopathologic review of 58 patients with biliary papillomatosis. Cancer. 2004;100(4):783–93.

    Article  PubMed  Google Scholar 

  7. Wan X, Zhang H, Chen C, Yang X, Wang A, Zhu C, Fu L, Miao R, He L, Yang H, Zhao H, Sang X. Clinicopathological features of GB papillary adenocarcinoma. Medicine (Baltimore). 2014;93(27): e131.

    Article  PubMed  Google Scholar 

  8. Misra S, Chaturvedi A, Misra NC, Sharma ID. Carcinoma of the GB. Lancet Oncol. 2003;4(3):167–76.

    Article  PubMed  Google Scholar 

  9. Albores-Saavedra J, Murakata L, Krueger JE, Henson DE. Noninvasive and minimally invasive papillary carcinomas of the extrahepatic bile ducts. Cancer. 2000;89(3):508–15.

    Article  CAS  PubMed  Google Scholar 

  10. Albores-Saavedra J, Henson DE, Klimstra D. Tumors of the GB, extrahepatic bile ducts, and ampulla of vater. Washington, DC: Armed Forces Institute of Pathology; 2000. Atlas of Tumor Pathology; 3rd series, fascicle 27. (1 of articles 4)

  11. Hoang MP, Murakata LA, Katabi N, Henson DE, Albores-Saavedra J. Invasive papillary carcinomas of the extrahepatic bile ducts: a clinicopathologic and immunohistochemical study of 13 cases. Mod Pathol. 2002;15(12):1251–8.

    Article  PubMed  Google Scholar 

  12. Ha GW, Lee MR, Kim JH. Cholecystocolic fistula caused by gallbladder carcinoma: preoperatively misdiagnosed as hepatic colon carcinoma. World J Gastroenterol: WJG. 2015;21(15):4765.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Kuo JY, Jao YT. Gallbladder papillomatosis and cholecystocolonic fistula: a rare combination. Am J Case Rep. 2014;15:466.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kang JS, Lee KB, Choi YJ, Byun Y, Han Y, Kim H, Kwon W, Jang JY. A comparison of outcomes in patients with intracholecystic papillary neoplasms or conventional adenocarcinomas of the gallbladder. HPB. 2021;23(5):746–52.

    Article  PubMed  Google Scholar 

  15. Wang Z, Wang L, Hua Y, Zhuang X, Bai Y, Wang H. Development and validation of a prognostic nomogram for gallbladder papillary adenocarcinoma. Front Oncol. 2023;16(13):1157057.

    Article  Google Scholar 

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Authors

Contributions

Planning—PS

Conduct—PS, JNB

Reporting—PS, JNB

Concepts and design—JNB

Data acquisition—PS

Data Interpretation—JNB

Manuscript preparation, editing, and review—PS, JNB

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Correspondence to Jyotsna Naresh Bharti.

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Saraf, P., Bharti, J.N. Gall Bladder Papillary Carcinoma Presenting as Cholecystocolic Fistula and Metastasizing to Pericholecystic Lymph Node: an Incidental and Rare Finding—a Case Report. SN Compr. Clin. Med. 5, 230 (2023). https://doi.org/10.1007/s42399-023-01571-4

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