Gallbladder cancer presenting as hemobilia on capsule endoscopy

• Published in: Journal of surgical case reports Vol. 2022; no. 5; p. rjac202
• Main Authors: Scarola, Samantha, Sibia, Udai S, Gibson, Glen
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-05-2022
• Subjects: Case Report
• ISSN: 2042-8812; 2042-8812
• DOI: 10.1093/jscr/rjac202

Abstract
Gallbladder adenocarcinoma is a rare gastrointestinal malignancy and is associated with a poor prognosis. These malignancies are most often discovered incidentally in $\sim$1% of all cholecystectomy procedures. We report an 80-year-old male patient with iron deficiency anemia, who underwent an unremarkable endoscopy and colonoscopy, and was subsequently found to have hemobilia discovered on capsule endoscopy. Magnetic resonance cholangiopancreatography revealed a space-occupying process involving the posterior wall of the gallbladder. The patient underwent an unremarkable laparoscopic cholecystectomy with final pathology revealing a well-differentiated, 8 cm intracystic papillary neoplasm with high-grade dysplasia involving the majority of the gallbladder, with focally invasive adenocarcinoma invading the muscular layer of the gallbladder wall. Postoperative staging work-up revealed no evidence of metastatic disease. Patient then underwent a radical resection of segments 4B/5 of the gallbladder fossa and lymph node resection of the porta hepatis. Final pathology revealed Stage I adenocarcinoma of the gallbladder (T1bNxM0).