Gallbladder carcinoma with situs inversus totalis

A 75-year-old man was initially admitted for cholangitis. CT scan revealed the patient had situs inversus totalis and a tumor in the transpositioned gallbladder. Gallbladder cancer was suspected and extended cholecystectomy was performed. Serosal invasion was unclear and the cystic duct margin was negative in frozen sections. Pathological examination indicated gallbladder adenocarcinoma with subserosal invasion. Both the external and cystic duct margins were negative and no metastasis was detected in the cystic duct lymph node. Situs inversus totalis can cause difficulty in surgical maneuvers as most surgeons are unfamiliar with mirror-image transposition of the viscera. In addition, it is necessary to carefully examine all features of the patient with situs inversus because coexisting anomalies are often found. We report a rare case of carcinoma in the transpositioned gallbladder with a review of the literature.