A CASE OF GALLBLADDER CANCER-ASSOCIATED WITH A COMMON BILE-DUCT NEUROMA, AND A CYSTIC LESION OF THE LIVER WITH HISTOLOGIC-FINDINGS SIMILAR TO THOSE OF AN INFLAMMATORY PSEUDOTUMOR

We report a rare case of gallbladder cancer associated with a common b ile duct neuroma, and a cystic liver lesion with histologic findings s imilar to an inflammatory pseudotumor, in a patient who had had no pre vious abdominal surgery. The patient was a 62-year-old man whose major complaint was fever. Ultrasonography and a computed tomography scan r evealed gallstones, an elevated lesion in the gallbladder, and a cysti c liver lesion. Endoscopic retrograde cholangiopancreatography demonst rated stenosis of the common bile duct. Cultures of the cystic fluid a nd gallbladder bile were positive for Staphylococcus aureus. The patie nt underwent hepatectomy (inferior S4, S5, and S6), cholecystectomy, r esection of the common bile duct, and right hemicolectomy. The resecte d specimens revealed gallbladder cancer with the microscopic appearanc e of a papillary adenocarcinoma, and a 12 x 4.5 x 3.5 cm cystic liver lesion with a wall 7 mm thick. Histologic studies of the wall of the c ystic liver lesion revealed infiltration by histiocytes and plasma cel ls, and the presence of fibrous connective tissue, which findings are characteristic of inflammatory pseudotumors. A 9 x 6 mm elevated lesio n, with the microscopic appearance of a neuroma, was resected from the common bile duct.