Report Highlights Second Case of Gallbladder Amoeboma Mimicking CCA

Özge Özkaya, MSc, PhD
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Publish Date

Researchers from Tunisia presented a very rare case of a patient with amoeboma of the gallbladder mimicking cholangiocarcinoma (CCA). 

“To our knowledge, there is only 1 case of gallbladder amoeboma in the literature, making this case report valuable,” the researchers wrote in a report published in the International Journal of Surgery Case Reports. 

Read more about the diagnosis of CCA

The case is that of a 62-year-old patient who presented with biliary colic that had been developing for the past 4 months.

The patient underwent magnetic resonance imaging (MRI) and thoracoabdominal computed tomography, which revealed a cholangiocarcinoma of the gallbladder extended to the liver. There was also probable localized peritoneal carcinosis.

The team performed extended cholecystectomy with lymphadenectomy to diagnose CCA.

Pathology examination confirmed an amoeboma of the gallbladder extended to the liver and duodenum.

The researchers said that their preferred therapeutic strategy was a hepatic parenchyma biopsy and amoebic serology followed by a therapeutic test based on metronidazole and, finally, a computed tomography scan to confirm the loss of the suspicious lesions.

“Gallbladder amoeboma is an exceptional entity, but it needs to be kept in mind in case of an atypical presentation of a cholangiocarcinoma,” the researchers concluded. “Evoking and confirming the diagnosis preoperatively makes it possible to avoid excessive surgery.”

Amoeboma is a pseudotumoral presentation of amebiasis, a parasitic infection caused by Entamoeba histolytica. Only 1 previous case of amoeboma of the gallbladder has been presented in the literature.

CCA is a group of rare malignant tumors that begin in the bile ducts. The disease is usually asymptomatic until advanced stages, when it can present with weight loss, abdominal pain, and malaise, depending on the location.

Reference

Ouadi Y, Hammami M, Frikha W, Kamoun H, Fterich F, Kacem MJ. Amoeboma of the gallbladder mimicking a cholangiocarcinoma: a case report. Int J Surg Case Rep. Published online August 11, 2023. doi:10.1016/j.ijscr.2023.108656