Paraganglion, a pitfall in diagnosis after regular cholecystectomy

• Published in: International journal of surgery case reports 2019-01, Vol.65, p.205-208
• Main Authors: Corten, Bartholomeus J.G.A., Leclercq, Wouter K.G., Dercksen, M. Wouter, van den Broek, Wilhelmus T., van Zwam, Peter H., Dejong, Cees H., Slooter, Gerrit D.
• Format: Article
• Language: English
• Subjects: Gallbladder cancer; Neuroendocrine neoplasm; Neuroendocrine tumour; Paraganglion
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2019.10.042

•Neuroendocrine neoplasms are a rarity after cholecystectomy and current literature is scarce.•Paraganglion of the gallbladder is an incidental benign finding.•A paraganglion can mimic the histopathologic appearance of neuroendocrine tumours. Neuroendocrine neoplasm of the gallbladder is an extremely uncommon diagnosis. We present a case of a benign gallbladder paraganglion that was initially incorrectly diagnosed as a neuroendocrine tumour (NET). A 27-year-old female with symptomatic gallstone disease underwent an uncomplicated laparoscopic cholecystectomy. Routine histopathologic examination suggested the presence of a small adventitial NET. However, histopathological revision was performed by our pathologist because of regional gallbladder carcinoma (GBC) treatment evaluation. The revision demonstrated the presence of a normal paraganglion, a preexistent structure that is only rarely encountered during routine histopathologic examination of the gallbladder. Neuroendocrine neoplasms of the gallbladder are extremely rare. Treatment varies from a simple cholecystectomy to extensive surgical resections. Chemotherapy is usually reserved for metastatic disease. In contrast, a gallbladder paraganglion is a benign entity not requiring additional treatment. A neuroendocrine neoplasm of the gallbladder may closely resemble a benign paraganglion. If a NET is suspected, the clinician should be aware of the histopathologic mimicry of a paraganglion prior to initiating additional treatments.