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Actinomycosis of the Gallbladder: A Case Report

Chih-Yuan Cheng, Hung-Kan Tseng, Shing-Jhong Long, Shih-Sung Chuang, Shien-Tung Pan

Abstract


Introduction: Actinomycosis of the gallbladder is extremely rare and may mimic a malignancy leading to delayed diagnosis and/or inappropriate treatment.

Presentation of case: Here we report the case of an 82-year-old man who presented with right upper abdominal discomfort for one month. Radiographically, an ill-defined mass was found in the gallbladder fossa that invaded the adjacent abdominal wall and liver bed. In addition, a stone was found in the gallbladder lumen. The imaging features suggested a gallbladder carcinoma. An initial CT-guided needle biopsy showed an inflammatory process. The subsequent open cholecystectomy revealed a contracted, thick-walled gallbladder surrounded by a soft tissue mass near the fundus. Histologically, the gallbladder revealed acute and chronic cholecystitis and microabscesses containing sulfur granules in the soft tissue mass, which showed Gram-positive filamentous bacilli. Under the diagnosis of gallbladder actinomycosis, the patient received post-operative antibiotics for 7 weeks and was well 5 months after diagnosis.

Conclusion: Our case demonstrated that a gallbladder actinomycosis should be considered in the differential diagnosis in patients with cholelithiasis and cholecystitis presenting an invasive mass in the gallbladder fossa.


Keywords


Actinomycosis; Gallbladder carcinoma; Taiwan

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References


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