Giant gallbladder case report with vascular endothelial growth factor (VEGF) serum level and mRNA expression evaluation

Giant gallbladder (GGB) is a rare condition and its pathogenesis could not be explained clearly. It can result from cholelithiasis, chronic cholecystitis or neoplasm, but more rarely if created congenitally. Adequate vasculatization should support the development of this entity. A 47-year-old lady presented with a dull pain and right upper quadrant abdominal mass. A computed tomography scan showed 27 × 25 × 12 cms cystic mass expanding to the right illiac fossae, surrounded by a homogenous capsule. There were neither stones nor mass in the biliary tract and total cholecystectomy was done. Patient recovered well without signs of cholestasis 5 years postoperatively. A few cases of giant benign gall bladder have been reported in literature; however, no study has tried to investigate the mechanism of its etiology. To support the enlargement of the tissue or organ there must be some growth factors along with adequate vascularization. Vascular endothelial growth factor (VEGF) serum level and VEGF messenger ribonucleic acid (mRNA) gene expression were increased in this case. This GGB case suggests a congenital factor as its etiology. Cholecystectomy may relieve uncomfortable symptoms with good results. The incidence of GGB accompanied by increased serum VEGF levels and mRNA gene expression supports the hypothesis that VEGF plays a major role in supporting the vasculogenesis of GGBs.