GALLBLADDER CANCER-ASSOCIATED WITH CHOLESTEROSIS

We report herein two cases of carcinoma in situ of the gallbladder ass ociated with cholesterosis. The patient in case 1 was an 81-year-old m an who underwent a cholecystectomy for cholelithiasis. The resected sp ecimens revealed gallbladder cancer in the fundus which was diagnosed histologically as mucinous carcinoma. Other findings included 13-mm, 1 2-mm, and 5-mm polypoid lesions in the neck of the gallbladder which m acroscopically appeared to be cholesterol polyps, but histologically d emonstrated carcinoma in situ with cholesterosis. The patient in case 2 was a 76-year-old man in whom ultrasonography revealed a highly echo genic, elevated lesion in the gallbladder. Cholecystectomy was perform ed, and a 33 x 28-mm papillary, elevated lesion with cholesterosis was resected from the neck of the gallbladder. Histologically, this was d emonstrated to be papillary adenocarcinoma in situ with cholesterosis surrounded by glandular dysplasia. The distribution of the carcinomas and cholesterosis in both of these patients suggests that the adenoma or carcinoma of the gallbladder had occurred first. Then, the tumor ep ithelium absorbed cholesterol from the bile, and foamy cells were prod uced. Thus, when treating cholesterol polyps, it should be remembered that it is often difficult to distinguish between cholesterol polyp an d gallbladder cancer with cholesterosis.