DOI: https://doi.org/10.36347/sjmcr.2026.v14i08.038

Pages: 1916-1919

Background: Intracholecystic papillary neoplasm (ICPN) is an uncommon preinvasive epithelial tumor of the gallbladder that develops as an exophytic intraluminal lesion and exhibits a broad spectrum of histological features. Since its recognition as a distinct clinicopathological entity, ICPN has attracted increasing attention because of its heterogeneous morphology and its potential to progress to invasive carcinoma [4,8]. Case presentation: A female patient presented with persistent right upper quadrant pain. Abdominal ultrasonography suggested calculous cholecystitis, and laparoscopic cholecystectomy was performed without additional preoperative cross-sectional imaging. Gross examination of the surgical specimen unexpectedly demonstrated a thin-walled gallbladder measuring 8.5 × 4 × 3 cm, containing a 3.5 × 2 cm intraluminal polypoid mass without gallstones. Microscopic examination revealed an intracholecystic papillary neoplasm associated with a focal invasive adenocarcinoma corresponding to pathological stage pT1b. The patient was lost to follow-up eight months after surgery. Conclusion: This case illustrates the diagnostic challenge posed by ICPN, which may clinically mimic common benign gallbladder diseases and remain undetected before surgery. It also underlines the pivotal role of meticulous gross examination and comprehensive histopathological assessment in identifying this rare neoplasm and accurately documenting an associated invasive component.