Xanthogranulomatous Cholilithiasis - Diagnostic Challenge With Significant Surgical Complexity

Xanthogranulomatous cholecystitis (XGC) with cholelithiasis (gallstones) is a rare, benign, but aggressive form of chronic inflammation that often misdiagnosed as gallbladder cancer due to significant wall thickening that mimics malignancy on imaging (CT, MRI, Ultrasound). It often creates significant challenges in making an accurate diagnosis because its clinical features and imaging findings closely resemble those of gallbladder carcinoma. This case report of a lady in mid-eighties whose laparoscopic cholecystectomy was markedly complicated by dense adhesion and distorted anatomy. A definite diagnosis could only be made after a detailed histopathology examination that showed the typical characteristics of XGC. This case report emphasizes the diagnostic complexity, the essential role of histopathology, and the significant surgical challenges encountered during management.