Tuberculosis or Gallbladder carcinoma? A confusing presentation in an endemic region

INTRODUCTION AND IMPORTANCE: Gallbladder tuberculosis (GT) is an extremely rare clinical entity that represents only 1 % of abdominal tuberculosis cases. Preoperatively, most patients are misdiagnosed as chronic cholecystitis or gallbladder malignancy. CASE PRESENTATION: We report the case of a 43-year-old patient, whose clinic, imaging and biology were in favor of Gallbladder carcinoma. DISCUSSION: The clinical presentation of GT is varied and nonspecific, making the preoperative diagnosis of GT difficult; it may mimic acute cholecystitis to frank malignancy as seen in our case. Preoperatively, GT poses a diagnostic dilemma despite advanced imaging modalities, leading to missed diagnosis. The biology remains non-specific also. The diagnosis is usually made upon histological examination after cholecystectomy. CONCLUSION: Even though the clinical presentation and the radiology are aspecific and misleading, It seems to us justified to evoke the diagnosis of tuberculosis faced with such a presentation, especially if the patient comes from a tuberculosis-endemic country. Diagnosis is made upon histopathological examination.