Document Type

Article

Publication Title

Cureus

Abstract

Gallbladder adenocarcinoma is an uncommon gastrointestinal malignancy that is frequently discovered incidentally during cholecystectomy. Intraoperative frozen section is often used to guide surgical decision-making but has inherent limitations, particularly in assessing depth of invasion. We report the case of a 78-year-old female who underwent an elective laparoscopic cholecystectomy for a gallbladder mass. Intraoperative frozen section demonstrated a tubulovillous adenoma with at least carcinoma in situ. Subsequent permanent histologic evaluation revealed a moderately differentiated adenocarcinoma invading the hepatic-side perimuscular connective tissue, consistent with pT2b disease. Despite the advanced T stage, the tumor exhibited several relatively favorable histologic features, including negative margins and absence of lymphovascular invasion, although nodal assessment was limited. The cystic duct margin showed focal high-grade dysplasia without invasive carcinoma. This case highlights the diagnostic limitations of frozen-section analysis in gallbladder pathology and underscores the importance of integrating final histologic findings when assessing prognosis and postoperative management in T2b disease.

DOI

10.7759/cureus.109698

Publication Date

5-26-2026

Keywords

gallbladder adenocarcinoma, high-grade dysplasia, t2b disease, tubulovillous adenoma, tumor invasion depth

ISSN

2168-8184

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