Diagnostic dilemma: intracholecystic neoplasm of the gallbladder mimicking malignancyin a tertiary care centre in Tamil Nadu

A 65-year-old female presented to a tertiary care hospital in a western district of Tamil Nadu with complaints of right upper quadrant abdominal pain and reduced appetite for the past 3 days. CECT abdomen revealed cholelithiasis with a thickened gall bladder wall, along with a lesion arising from the fundus and projecting into the lumen, which is suspicious of malignancy. The patient has been taken for a laparoscopic cholecystectomy. Grossly, the gall bladder showed a thickened wall with an exophytic growth with the papillary projections in the fundus. Microscopically, after thorough analysis of the specimen, it has been concluded as a low-grade intracholecystic papillary neoplasm of Gall bladder-biliary type. Immunohistochemical studies have also been performed to confirm the diagnosis, which showed positivity for EMA (MUC1) and CK7. In this case report, we discuss the clinicopathologic perspective of this distinct entity and evidence that ICPN may mimic carcinoma radiologically and macroscopically. Thus, a thorough histopathological examination is necessary for the diagnosis of ICPN, which exhibits a good prognosis.