Gall Bladder Papillary Carcinoma Presenting as Cholecystocolic Fistula and Metastasizing to Pericholecystic Lymph Node: an Incidental and Rare Finding—a Case Report

Gallbladder papillary carcinoma is a less common form of gallbladder carcinoma that accounts for around 5% of all gallbladder malignancies. Because of its early manifestation and delayed invasion in the gallbladder wall, it has a better prognosis than adenocarcinoma. It is quite rare for it to manifest as cholecystocolic fistula. Imaging aids in the diagnosis of the lesion and associated fistula, as well as in determining the surgical extent of excision. Histology further aids in accurate diagnosis by recognizing the papillary architecture of the tumor as well as the extent of invasion. We herein present a case of a 51-year-old female who presented with symptoms of abdominal pain and vomiting for a month. Contrast-enhanced computed tomography showed thickened gallbladder wall with the presence of cholecystocolic fistula and enlarged pericholecystic lymph node. Cholecystectomy with excision of fistulous tract and lymph node was done, which showed gallbladder papillary carcinoma with metastasis to lymph node. After surgery, the patient received chemotherapy and was followed for 2 years with no symptoms of recurrence. To summarize, papillary gallbladder cancer is less prevalent and has a better prognosis than adenocarcinoma. Imaging and histology are critical in identifying the lesion and determining the best treatment option.