Gallbladder Adenomyomatosis Mimicking Carcinoma: A Diagnostic Dilemma

A69-year-oldmanpresentedwith right hypochondriac pain accompanied by postprandial nausea and vomiting for 2 months. Additional symptoms included fever and fatigue for 4 days. There was associated history of weight loss of approximately 6 kg over the past few months. Vital signs were normal, and he was febrile (38.3°C). His skin and sclerae weremildly icteric. He had no signs of liver failure. His abdomen was soft, with tenderness noted in the right hypochondriac region (Murphy sign positive); no tenderness was noted elsewhere, and there was no evidence of ascites. The tip of the gallbladder was palpable in the right 9th costal margin. Laboratory evaluation revealed mild conjugated hyperbilirubinemia (total bilirubin level, 2.1 mg/dL; direct bilirubin level, 1.1 mg/dL), with normal levels of transaminases and alkaline phosphatase. Mild hypoalbuminemia was present. Other investigations were unremarkable. On the basis of the clinical and laboratory findings, the patient was evaluated for obstructive jaundice, and ultrasonography (US) was performed.