Giant Gall Bladder Stone Mimicking as a Gall Bladder Mass: A Diagnostic Challenge Between Gall Bladder Carcinoma and Xanthogranulomatous Cholecystitis

Abstract

Giant gallstones, although a rare phenomenon, pose significant diagnostic challenges, particularly when they mimic gall bladder carcinoma (GBC). Gallstones larger than 5 cm or weighing over 70 g are categorized as giant gallstones and are often associated with increased risk for conditions such as GBC, Mirizzi’s syndrome, and xanthogranulomatous cholecystitis (XGC). This case report presents a woman in her mid-40s with symptomatic gallstone disease, where preoperative imaging and elevated serum CA 19-9 levels raised suspicion of GBC. However, intraoperative findings revealed a giant gallstone mimicking a gallbladder mass, with subsequent histopathology confirming XGC. This case highlights the complexities in distinguishing between GBC and XGC due to their overlapping clinical presentations and imaging findings. It underscores the importance of thorough radiological evaluation and high clinical vigilance in managing such cases, as early and accurate diagnosis is crucial for determining the appropriate surgical approach and optimizing patient outcomes.