Gallbladder tuberculosis as an incidental calcified mass in an elderly male: a case report

Gallbladder tuberculosis (GBT) is exceptionally rare and may closely mimic gallbladder carcinoma. We report a 71-year-old male with a history of successfully treated pulmonary tuberculosis who was asymptomatic and incidentally found on screening ultrasonography to have a calcified mass at the gallbladder fundus. Contrast-enhanced computed tomography (CT) demonstrated a 2 × 4 cm calcified fundal lesion with focal wall thickening, raising strong suspicion of malignancy. Laparoscopic cholecystectomy with intraoperative frozen section was performed. Despite severe inflammatory adhesions suggestive of invasive cancer, frozen section and final histopathology confirmed caseating granulomatous inflammation consistent with GBT, and surgery was limited to simple cholecystectomy. The postoperative course was uneventful, and the patient was referred for antituberculous therapy. GBT should be considered in the differential diagnosis of calcified gallbladder masses to avoid overtreatment.