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A rare presentation of a gallbladder mass

Journal Volume 82 - 2019
Issue Fasc.1 - Clinical images
Author(s) S. Malik, P. Gupta, H. S. Mandavdhare, H. Singh, V. Sharma
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Postgraduate Institute of Medical Education and Research, Gastroenterology, Nehru Hospital, Chandigarh.

A 47-year-old female presented with complaints of abdominal pain for last 3 months and fever for last 2 weeks. She gave history of fever with occasional chills and rigors. There was no history of jaundice, nausea, vomiting, hematemesis, melena, significant anorexia or weight loss. She had been operated for extradural meningioma 2 years back. Her vitals were stable at presentation. General physical examination revealed pallor. Abdominal examination revealed tenderness in right hypochondrium and presence of globular lump, extending 4 cm below right costal margin. Liver function tests showed hypoalbuminemia (albumin-2.8g/ dL) and raised alkaline phosphatase (ALP-372 IU; normal-100-250)). Her coagulogram and renal function tests were within normal limits. CECT of the abdomen revealed a large low-attenuation mass involving segments IV and V of liver (Figure 1a). The gallbladder was only partly visualized in neck and proximal body and showed continuity with the lesions. An upper gastrointestinal endoscopy (UGIE) was done (Figure 1b). What is your diagnosis?

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PMID 30888765