A LARGE INFLAMMATORY POLYP OF THE GALLBLADDER MASQUERADING AS GALLBLADDER CARCINOMA

An inflammatory polyp of the gallbladder is a rare variant of benign g allbladder polyp. Differentiation between an inflammatory polyp and po lypoid gallbladder carcinoma is difficult when the polyp is more than 1 cm in diameter. We report a rare case of a large inflammatory polyp of the gallbladder masquerading as gallbladder carcinoma in a 37-year- old Japanese woman who was incidentally diagnosed with a large gallbla dder polyp, measuring 1 cm in diameter, by ultrasonography. She was as ymptomatic and physical examination was unremarkable. Abdominal ultras onography and endoscopic ultrasonography revealed three polypoid lesio ns in the gallbladder. One lesion was an isoechoic polyp, measuring 15 x 8 mm, showing a nodular surface and located in the fundus of the ga llbladder. The other two lesions were hyperechoic polyps, measuring 5 x 5 mm, in the body of the gallbladder. Computed tomography and magnet ic resonance imaging revealed marked enhancement of the largest polypo id lesion by dynamic study, and no lymph node enlargement was noted. E ndoscopic retrograde cholangiography revealed a 12 x 8 mm polyp with a n irregular surface in the fundus of the gallbladder. Superselective a ngiography of the cystic artery revealed neovascularity and a tumor st ain in the fundus of the gallbladder. Cholecystectomy with lymph node dissection was performed. Intraoperative frozen section diagnosis of t he largest polyp was an inflammatory polyp of the gallbladder. The oth er two polyps were cholesterol polyps. Inflammatory polyp should be co nsidered as a differential diagnosis of hypervascular gallbladder poly ps that measure more than 1 cm in diameter.