담낭암은 드물지만 치명적인 악성 종양으로 초기에는 증상이 없어 대부분의 담낭암이 늦게 진단되고, 급속하게 인접 장기로 전이되기 때문에 예후가 불량하다. 따라서 담낭암을 조기에 발견하는 경우는 드물고, 담낭담석이나 용종으로 수술적 절제를 시행한 후 우연히 발견되는 때가 대부분이다. 저자들은 급성 무결석 담낭염 환자에서 초음파 내시경을 통해 비교적 조기에 담낭관암을 발견하여 성공적으로 치료할 수 있었던 증례를 경험하였다. 이에 문헌고찰과 함께 보고한다.

We present an interesting case of acute acalculous cholecystitis which was diagnosed as cystic duct cancer after endoscopic ultrasonography (EUS). A 63-year-old man visited to an emergency room (ER) because of right upper quadrant (RUQ) abdominal pain. The patient had fever up to 38.2℃ and tenderness at RUQ abdomen. The Murphy’s sign was positive. Laboratory tests showed elevated white blood cell count and abnormal liver function test. The computed tomography scan revealed a distended gallbladder with inflammation without gallstone. Emergent gallbladder drainage was performed at ER. The cholecystogram via percutaneous tube and EUS revealed hypoechoic intraluminal mass at cystic duct. Laparoscopic cholecystectomy was performed at first, and the frozen pathologic examination revealed adenocarcinoma in the cystic duct. The extended cholecystectomy was performed after a month and there was no residual tumor in the liver bed and lymph nodes. The final staging of GBC was revealed as pT2N0M0.

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ACKNOWLEDGMENTS
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REFERENCES

• Hogyung Jun(Department of Internal Medicine, Jeju National University College of Medicine, Jeju)
• Eun Kwang Choi(Department of Internal Medicine, Jeju National University College of Medicine, Jeju)
• Chang Lim Hyun(Department of Pathology, Jeju National University College of Medicine, Jeju)
• Sang Hyub Lee(Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea)