Large gallstone initially diagnosed as porcelain gallbladder with malignant change.

A 71-year-old man presented with fever and right hypochondrium colicky pain. On examination, a non-tender, palpable gallbladder was felt. Serum biochemistry revealed elevated alkaline phosphatase and gamma-glutamyl transferase, bilirubin and CA19-9 (52 units/mL). A contrast Computed Tomography (CT) scan and Magnetic Resonance Imaging (MRI) of the abdomen showed porcelain gallbladder, intraluminal mass within gallbladder and local lymphadenopathy (figure 1). Patient was offered a laparoscopic cholecystectomy with possibility of conversion to open after …