Azami Tetsushi, Takano Yuichi, Tamai Naoki, Noda Jun, Yamawaki Masataka, Niiya Fumitaka, Nishimoto Fumiya, Maruoka Naotaka, Ogawa Takafumi, Nagahama Masatsugu
Division of Gastroenterology, Department of Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama-shi, Yokohama, Kanagawa, 227-8501, Japan.
Department of Diagnostic Pathology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
Clin J Gastroenterol. 2025 Feb;18(1):188-194. doi: 10.1007/s12328-024-02079-7. Epub 2024 Dec 12.
Intracholecystic papillary neoplasm and cholecystocolonic fistula are both relatively rare diseases. Here, we report a case of a preoperative intracholecystic papillary neoplasm associated with invasive carcinoma and a transverse colonic fistula of the gallbladder. A 79-year-old female patient presented to our hospital with persistent right upper quadrant pain for several months and was suspected to have intracholecystic papillary neoplasm associated with an invasive carcinoma by computed tomography and endoscopic ultrasound. A gallbladder tumor biopsy was pathologically diagnosed as intracholecystic papillary neoplasm. Preoperative cholecystocolonic fistula diagnosis enabled planning not only for cholecystectomy, but also for transverse colon partial resection. Pathological examination of the resected specimen revealed intracholecystic papillary neoplasm associated with an invasive carcinoma with subserosal invasion. No malignant findings were observed in the fistula. This is a rare condition, but the presence or absence of cholecystocolonic fistula should be considered before performing intracholecystic papillary neoplasm surgery.
胆囊内乳头状瘤和胆囊结肠瘘均为相对罕见的疾病。在此，我们报告一例术前诊断为胆囊内乳头状瘤合并浸润性癌及胆囊横结肠瘘的病例。一名79岁女性患者因持续右上腹疼痛数月前来我院就诊，经计算机断层扫描和内镜超声检查怀疑患有胆囊内乳头状瘤合并浸润性癌。胆囊肿瘤活检经病理诊断为胆囊内乳头状瘤。术前诊断出胆囊结肠瘘不仅有助于规划胆囊切除术，还能规划横结肠部分切除术。切除标本的病理检查显示胆囊内乳头状瘤合并浸润性癌，癌组织侵犯至浆膜下。瘘管未见恶性病变。这是一种罕见的情况，但在进行胆囊内乳头状瘤手术前应考虑是否存在胆囊结肠瘘。
