Cavernous Hemangioma of the Gallbladder Masquerading as a Carcinoma

First report of a gallbladder hemangioma coexisting with gallstones: a case report and literature review of a rare finding

Background

Gallbladder hemangioma is an exceptionally rare entity, with only ten cases reported in literature hitherto. The here described case is the first report of a gallbladder hemangioma coexisting with gallstones.

Case presentation

A 76-year-old male was hospitalized following repeated episodes of epigastric pain. Patient’s medical history included primary hypertension, type 2 diabetes mellitus, dyslipidemia, obesity and hyperuricemia. Physical examination revealed marked pain in the right hypochondriac region, and laboratory workup was notable for mildly elevated glycemia (125 mg/dL) and pancreatic amylase (60 IU/L). Abdominal ultrasound showed multiple gallstones, a thickened gallbladder wall and mild edema of the perivisceral adipose tissue as well as a hepatic angioma. During surgery, an incidental subserosal nodule of about 1 cm was detected within the gallbladder fundus. After surgery, the clinical course was uneventful and the patient was discharged. Histopathological examination of the subserosal nodule showed multiple dilated vascular channels within a sclerosing matrix, a finding consistent with a cavernous hemangioma. Diffuse chronic cholecystitis was also present.

Conclusions

Gallbladder hemangiomas represent a rare, likely underdiagnosed condition which can be undetected during the preoperative workup.

Spontaneous Rupture of Gallbladder Hemangioma Presenting as Hemoperitoneum

Hemangioma of the gallbladder is rare, with less than 10 cases reported in the literature. It may represent a hamartomatous proliferation of connective tissue in the gallbladder or may be congenital in origin. Although liver hemangiomas rarely present with spontaneous rupture, it has not been documented in gallbladder hemangiomas. This report presents a case of gallbladder hemangioma that ruptured spontaneously and presented with hemoperitoneum.