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CASE REPORT article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1535894
Xanthogranulomatous cholecystitis with elevated CA 19-9 masquerading as gallbladder cancer on radiology: A case report
Provisionally accepted- Jiangxi Provincial People's Hospital, Nanchang, China
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Xanthogranulomatous cholecystitis (XGC) is a rare type of cholecystitis which is characterized by the proliferation of xanthoma within the gallbladder wall. Although XGC is a benign disease, it can often be mistaken for gallbladder carcinoma (GBC) due to the radiological finding of a thickened gallbladder wall. This article presents a case in which a 63-year-old female was referred to our hospital with a clinical suspicion of a gallbladder tumor. Blood tests revealed a serum CA19-9 level of 433.00 U/mL. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) revealed a thickened gallbladder that had an obscure border with the liver. Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET-CT) showed a high uptake of FDG in the gallbladder. Consequently, due to the preoperative diagnosis of gallbladder cancer with liver invasion, the patient underwent a conversion from laparoscopic to open radical surgery. This procedure encompassed a partial hepatectomy involving the anatomical resection of segments IVB and V, cholecystectomy, choledochotomy, bilateral hepaticojejunostomy with Roux-en-Y anastomosis, as well as a lymphadenectomy. However, this case was later histopathologically confirmed as XGC after the operation. In this case, FDG-PET findings resulted in a false-positive for the diagnosis of GBC.
Keywords: Xanthogranulomatous cholecystitis, Gallbladder carcinoma, MRI, CT, 18F-FDG PET/CT
Received: 09 Dec 2024; Accepted: 14 Apr 2025.
Copyright: © 2025 Qi, Luo, Shao, Chen and Liao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fengxiang Liao, Jiangxi Provincial People's Hospital, Nanchang, China
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