Author : Ashutosh Gupta, Amit Choraria, Shantanu Tiwari, Vishakha Tikeykar, Vivek Chaudhary
Abstract : Case Report: 7 year old symptomatic girl was diagnosed with gall bladder polyp on ultrasonography and
MRCP (magnetic resonance cholangiopancreatography). Laparoscopic cholecystectomy was performed
and patient was discharged on 2nd post operative day without any complications. Histopathology and
Immunohistochemistry revealed pyloric gland adenoma with squamoid morules.
Discussion: Gall bladder polyps are seen in 5% of the adult population around the world but rarely seen in
children. Polyps have the potential to convert into malignancy and hence early diagnosis and differentiation
Most of the patients with gall bladder adenomas are adult females. Majority of the adenomas (91%) are
single. Squamoid morules was found in 28% and columnar oxyphil cells in 2% of these adenomas. Highgrade
dysplasia/carcinoma in situ was seen in 27% of them and low-grade dysplasia in 15%. However, only
1% invasive adenocarcinomas were diagnosed in pyloric gland adenomas, both of which were intestinal
type. For symptomatic patients who have pain and dyspepsia, cholecystectomy is the recommended
treatment. For asymptomatic or incidentally detected patients, the indications for cholecystectomy should
be age more than 50 years, solitary polyp greater than 10mm in largest dimension, accompanying gall
stones and increase in size on serial sonographies.
Conclusion: As per our knowledge the case we report is the first case of gallbladder pyloric adenoma with
squamoid morules in pediatric age group. Treatment with simple cholecystectomy is recommended in view
of literature suggesting pre malignant lesion.
Keywords: Gall bladder polyp, Pyloric gland type, Adenoma.