Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Gallbladder adenoma-Rare-Considered premalignant lesion-Minimal to no risk if < 1 cm• Papillomatosis: Multiple gallbladder adenomas• Adenomyomatosis: Gallbladder wall hyperplasia that can be diffuse, possibly premalignant• Leiomyomas, lipomas, hemangiomas, and heterotopic GI tissue are all other possible benign biliary neoplasms• Approximately 67% of benign biliary neoplasms are polyps, adenomatous papillomas, or bile duct adenomas; not known to have malignant potential• 47% of benign biliary neoplasms found in periampullary region and 27% found in common bile duct +++ Epidemiology + • 5% incidence of gallbladder polyps of which 50% are cholesterol polyps• < 1% incidence of benign biliary tumors +++ Symptoms and Signs + • Asymptomatic• Biliary colic or cholecystitis• Jaundice• Anorexia• Fever• Nausea +++ Laboratory Findings + • Leukocytosis if cholecystitis or cholangitis is present• Hyperbilirubinemia• Elevated alkaline phosphatase level +++ Imaging Findings + • Right upper quadrant US -Shows thickened gallbladder wall for adenomyomatosis-Shows submuscular hyperechoic areas in cholesterol polyps-Shows hyperechoic polypoid structures without shadowing for gallbladder adenomas-Shows biliary dilatation and possible stricture for benign biliary neoplasms• ERCP and percutaneous transhepatic cholangiogram (PTC) reveal stricture and proximal biliary dilatation, suggesting benign biliary neoplasms +++ Rule Out + • Possible malignancy making resection often necessary to verify diagnosis + • History and physical exam• CBC• Liver function tests• Carcinoembryonic antigen (CEA) and CA 19-9• Right upper quadrant US• PTC or ERCP +++ Surgery + • Cholecystectomy for gallbladder adenomatous polyps > 1 cm• Resection of biliary stricture and bilio-enteric reconstruction for benign biliary neoplasms causing jaundice or cholangitis +++ Complications + • Biliary leak or stricture +++ References ++Baillie J: Tumors of the gallbladder and bile ducts. J Clin Gastroenterol 1999;29:14. [PubMed: 10405225] ++Bismuth H, Majno PE: Hepatobiliary surgery. J Hepatol 2000;32(1 Suppl):208. Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth