Adenomyomatosis is a condition where the walls of your gallbladder become thickened. Although adenomyomatosis is noncancerous, it can look like cancer in imaging tests.

Your gallbladder is a small pear-shaped organ in your abdomen. Its function is to store and concentrate bile that’s made in your liver. Bile helps with digestion by breaking down fats.

There are several conditions that may affect the gallbladder. One of these is called adenomyomatosis, which causes the wall of the gallbladder to thicken.

Keep reading to learn more about adenomyomatosis as well as its symptoms, what causes it, and how it’s diagnosed and treated.

Adenomyomatosis is a condition in which the walls of the gallbladder become thickened. It also leads to the formation of tiny pockets in the gallbladder tissue called Rokitansky-Aschoff sinuses.

Adenomyomatosis is a benign (noncancerous) condition. However, sometimes it can be mistaken for cancer in imaging tests.

There are a few different types of adenomyomatosis:

  • Local: Local adenomyomatosis is the most common type. It involves thickening at one site, typically at the fundus, the widest part of your gallbladder. It’s also referred to as fundal adenomyomatosis.
  • Annular: Annular adenomyomatosis involves an area of tissue thickening around the circumference of the gallbladder. This leads to the inside of the gallbladder having an hourglass-like shape.
  • Segmental: Segmental adenomyomatosis is a thickening of a larger area of tissue, typically extending past the fundus. The affected portion of the gallbladder contracts inward while the rest of the tissue appears normal.
  • Diffuse: Diffuse adenomyomatosis affects the entire gallbladder.
Illustration depicting different types of adenomyomatosis of the gallbladderShare on Pinterest
Types of adenomyomatosis of the gallbladder. Illustration by Wenzdai Figueroa

Many people with adenomyomatosis don’t have any symptoms. In fact, it’s often diagnosed incidentally during testing related to other health conditions.

When symptoms are present, they can include:

Some people with adenomyomatosis also have gallstones. These are solid pieces of material, often made of bilirubin or cholesterol, that develop in your gallbladder.

Adenomyomatosis happens when cells in the lining of the gallbladder grow more rapidly than normal. This is called hyperplasia and leads to the thickening of the gallbladder wall and the formation of Rokitansky-Aschoff sinuses.

What exactly causes adenomyomatosis to develop isn’t known. Chronic inflammation as well as gallstones have been linked with the condition.

Adenomyomatosis is observed in 2–8% of people who’ve had their gallbladders removed.

Most people who are diagnosed with adenomyomatosis are in their 50s. The condition may also be more prevalent in people assigned female at birth, although there’s some disagreement on this.

One of the first tests that may be used to diagnose adenomyomatosis is ultrasound. During an ultrasound, a radiologist will look for findings characteristic of adenomyomatosis, including:

  • thickening of the gallbladder wall
  • Rokitansky-Aschoff sinuses
  • the presence “comet tail artifacts,” a reflection of the ultrasound off of cholesterol crystals in the affected areas

Other imaging techniques that may be used along with ultrasound include MRI scan and CT scan.

Imaging can sometimes be sufficient to diagnose adenomyomatosis. However, when imaging is inconclusive, a biopsy may be done to rule out gallbladder cancer, which is often aggressive and has a poor outlook.

While a doctor may do laboratory tests as a part of diagnosis, the results of these tests are typically normal for people with adenomyomatosis.

If you’re confirmed to have adenomyomatosis and don’t have any symptoms, you may not need treatment. Instead, your doctor may choose to monitor your condition periodically using ultrasound.

When adenomyomatosis is causing symptoms or cannot be differentiated from gallbladder cancer, the main treatment is removal of the gallbladder, called a cholecystectomy.

The outlook for adenomyomatosis is typically good. The condition is benign, and many people experience no symptoms.

Because the gallbladder isn’t an essential organ, you can live a typical, active life if you had your gallbladder removed due to adenomyomatosis. However, you may need to make some dietary adjustments, such as avoiding fatty foods.

Adenomyomatosis is a condition where the walls of your gallbladder become thickened and tiny pockets called Rokitansky-Aschoff sinuses develop. It’s often asymptomatic.

While adenomyomatosis is benign, it can resemble gallbladder cancer in imaging tests. As such, a thorough evaluation is needed to rule out cancer.

Removal of the gallbladder is the main treatment for adenomyomatosis.