• Muhammet Burak Kamburoğlu, İlke Aktuğ Buzkan, Ali Muhtaroglu, Yesim Akdeniz, and Fatih Altintoprak.
• General Surgery Clinic, Health Sciences University Derince and Training and Research Hospital, İzmit-Türkiye.
• Ulus Travma Acil Cerrahi Derg. 2024 Nov 1; 30 (11): 839841839-841.

AbstractWe present a challenging case at our facility involving a 70-year-old female with a history of hypertension who was diagnosed with malignant ovarian neoplasia. Preoperative imaging revealed a 6 x 6 x 2.5 cm mass in liver segment 6, initially suspected to be metastatic disease. The patient had undergone a laparoscopic cholecystectomy 11 years prior. Despite repeated biopsies and a high fluorodeoxy-glucose (FDG) uptake value of 9.87 on positron emission tomography-computed tomography (PET-CT), the exact nature of the mass remained undetermined. However, during a total abdominal hysterectomy and bilateral salpingo-oophorectomy, an excisional biopsy of the liver lesion identified it as an abscess formed around a gallstone, presumably spilled during the previous cholecystectomy. This case highlights a rare but significant diagnostic challenge, wherein a gallstone shed during gallbladder surgery mimicked a metastatic liver mass. It underscores the importance of considering a patient's surgical history in differential diagnoses, especially when encountering atypical abdominal masses.

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