Published online Jul 25, 2015. doi: 10.4253/wjge.v7.i9.912
Peer-review started: March 28, 2015
First decision: April 10, 2015
Revised: April 27, 2015
Accepted: May 26, 2015
Article in press: May 27, 2015
Published online: July 25, 2015
Detection of polypoid lesions of the gallbladder is increasing in conjunction with better imaging modalities. Accepted management of these lesions depends on their size and symptomatology. Polyps that are symptomatic and/or greater than 10 mm are generally removed, while smaller, asymptomatic polyps simply monitored. Here, a case of carcinoma-in-situ is presented in a 7 mm gallbladder polyp. A 25-year-old woman, who had undergone a routine cholecystectomy, was found to have an incidental 7 mm polyp containing carcinoma in situ. She had few to no risk factors to alert to her condition. There are few reported cases of cancer transformation in gallbladder polyps smaller than 10 mm reported in the literature. The overwhelming consensus, barring significant risk factors for cancer being present, is that such lesions should be monitored until they become symptomatic or develop signs suspicious for malignancy. In our patient’s case this could have led to the possibility of missing a neoplastic lesion, which could then have gone on to develop invasive cancer. As gallbladder carcinoma is an aggressive cancer, this may have led to a tragic outcome.
Core tip: Current guidelines for management of gallbladder polyps recommend cholecystectomy for polyps with size > 10 mm and/or presence of symptoms. Considering some cases of carcinoma in polyps with size less than 10 mm have been seen, consideration of a cholecystectomy for smaller size polyps is warranted.