Gallstone in abdominal wall - A complication of laparoscopic cholecystectomy

A 39-year-old woman presented with abdominal wall mass 9 years after she underwent laparoscopic cholecystectomy for symptomatic gallstones. After surgical resection, a pathologic examination identified an abscess cavity within the abdominal wall that was surrounded by a wide, diffuse, poorly defined wall of dense fibrous tissue. An examination did not show neoplastic tissue. The cavity was bile-stained and contained a 2.5-cm gallstone. This case shows a complication of laparoscopic cholecystectomy. Gallstones spilled during the extraction of the gallbladder through the abdominal wall incision may lead to a reactive process that clinically and microscopically may resemble a fibro-proliferative disorder, including a neoplastic process. This complication of laparoscopic cholecystectomy is rare. Pathologists must be aware of its occurrence because examination of the solid fibrous wall may lead to diagnoses of reactive or neoplastic fibro-proliferative processes.