PMC8702359_01
(a) CT A/P. The asterisk marks the RIGHT ovarian cyst, which was evaluated during the index operation. (b) CT A/P at OSH. The coronal view (right) and axial view (left) of porcelain gallbladder. The asterisk marks the gallbladder with a calcified wall.
CRIS2021-6455540.001.jpg
PMC8702359_01_CRIS2021-6455540.001.jpg
fig1
On imaging, there was no evidence of distant metastasis, but a small right ovarian cyst and calcification of the gallbladder wall were noted (Figure 1).
CT A/P. The asterisks mark the enlarging right ovarian lesion and a new left ovarian lesion.
CRIS2021-6455540.002.jpg
PMC8702359_01_CRIS2021-6455540.002.jpg
fig2
The patient represented to clinic with CT findings of growth in the right ovarian cyst, from 4 to 11 cm, with a new 6 cm complex cystic/solid mass along the left pelvic sidewall (Figure 2).
The appendiceal lumen (*) is focally involved by adenocarcinoma, though there is an abundance of deep infiltrating carcinoma, extending onto the serosa (bracket).
CRIS2021-6455540.003.jpg
PMC8702359_01_CRIS2021-6455540.003.jpg
fig3
At that time, her pathology was also reviewed (Figure 3).
Sections of the gallbladder showed thickened hyalinized wall (*), infiltrated by invasive carcinoma (bracket), and associated widespread high grade biliary intraepithelial neoplasia (arrow).
CRIS2021-6455540.004.jpg
PMC8702359_01_CRIS2021-6455540.004.jpg
fig4
The carcinoma extended through the visceral peritoneum onto the serosal surface and into the pericystic soft tissue on the hepatic bed surface (Figure 4).
The gallbladder carcinoma (a) infiltrating the fibrotic wall of the gallbladder, with overlying high grade biliary intraepithelial neoplasia, has the same morphologic appearance as the appendiceal carcinoma (c), which had an abundance of lymphovascular space invasion (b).
CRIS2021-6455540.005.jpg
PMC8702359_01_CRIS2021-6455540.005.jpg
fig5
The original appendiceal specimen slides were reviewed and found to be similar histologically to the gallbladder adenocarcinoma (Figure 5).