Segmental type of gallbladder adenomyomatosis – Case report and literature review

IntroductionAdenomyomatosis of the gallbladder is a benign mural disorder characterized by a thickened wall, proliferation and distention of Rokitansky–Aschoff sinuses surrounded by proliferated fibromuscular tissue.AimOverview of radiological imaging methods used to evaluate the segmental type of adenomyomatosis of the gallbladder.Case reportThe patient was admitted to the Emergency Department with typical symptoms of hepatic colic. Ultrasonography did not allow the exclusion of gallbladder cancer and diagnosis required clarification in Multidetector CT and MR with MR cholangiopancreatography. The surgical pathological specimen revealed segmental form of adenomyomatosis with cholelithiasis and chronic inflammation.Results and discussionAdenomyomatosis is not considered a pre-cancerous condition, but elevated intraluminal pressure, gallstones and chronic inflammation are risk factors for gallbladder cancer. The most common imaging methods used to diagnose adenomyomatosis of gallbladder are US and MRI with MRCP.ConclusionsThe segmental type of gallbladder adenomyomatosis with a tendency of cholelithiasis, and higher risk of gallbladder malignancies, is a direct recommendation for cholecystectomy. Despite improvements of diagnostic imaging methods differentiation of segmental adenomyomatosis from early gallbladder cancer still remains challenging.