ISSN: 2474-3682 Mustafa and Shinil . Clin Med Img Lib 2020, 6:157 DOI: 10.23937/2474-3682/1510157 Volume 6 | Issue 4 Clinical Medical Image Library Open Access

IMAGE ARTICLE Clinical Image: Porcelain Nada Mustafa, MD and Shinil K Shah, DO*

Check for Department of Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, updates USA

*Corresponding author: Shinil K Shah, Department of Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 4.156, Houston, TX 77030, USA, Tel: 713-500-7277, Fax: 713-383-3708

A 68-year-old man with a known history of cholelithi- tions) and an incidental 7 cm right renal mass. Patient asis presented with worsening epigastric and right up- underwent laparoscopic in conjunc- per quadrant discomfort. He was afebrile, with mild tion with laparoscopic radical nephrectomy. Intraoper- leukocytosis (13.3 K/CMM) and normal liver function ative findings demonstrated porcelain gallbladder with tests. Ultrasound and CT (abdomen/pelvis) showed dense fibrotic adhesions. Pathology of the gallbladder cholelithiasis with gallbladder wall calcifications (Figure revealed cholelithiasis, chronic with focal 1A, Figure 1B and Figure 1C, arrow indicates calcifica- high-grade dysplasia and extensive calcified fibrosis of

Figure 1: Ultrasound of the abdomen (A) demonstrates calcification in the wall of the gallbladder (arrow); which is also documented on CT scan (B & C, arrow). A calcified is also noted on ultrasound (A) and CT scan (C).

Citation: Mustafa N, Shah SK (2020) Clinical Image: Porcelain Gallbladder. Clin Med Img Lib 6:157. doi. org/10.23937/2474-3682/1510157 Accepted: October 08, 2020; Published: October 10, 2020 Copyright: © 2020 Mustafa N, et al. This is an open-access content distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Mustafa and Shah. Clin Med Img Lib 2020, 6:157 • Page 1 of 2 • DOI: 10.23937/2474-3682/1510157 ISSN: 2474-3682 gallbladder wall. Right kidney pathology showed 5.4 cm malignancy, the true incidence of malignancy in porce- clear cell renal cell carcinoma (WHO/ISUP Grade 2) with lain gallbladder is thought to be significantly lower than clear margins. The patient had an uneventful recovery. previously reported. Operative management is indicat- Although historically associated with increased risks of ed in symptomatic patients.

Mustafa and Shah. Clin Med Img Lib 2020, 6:157 • Page 2 of 2 •