The quiet cyst: incidental diagnosis and conservative management of the first documented gallbladder ciliated foregut cyst in Palestine: a case report and literature review

Ciliated foregut cysts (CFCs) are rare congenital lesions derived from primitive foregut remnants, typically occurring above the diaphragm; involvement of the gallbladder is extremely uncommon, with only 17 cases reported previously. We present the 18th known case, and the first documented in Palestine, of gallbladder CFC in a 34-year-old female (G5 P4A1) who presented with sudden-onset left flank pain. Imaging revealed mild hydroureteronephrosis due to distal ureteric stones and incidentally identified a well-defined 7 mm cystic structure within the gallbladder fundus on computed tomography, confirmed by ultrasound. The patient had no biliary symptoms, and all other abdominal findings were normal. She was managed conservatively and discharged with outpatient surveillance. Although exceedingly rare, gallbladder CFCs should be considered in the differential diagnosis of incidental gallbladder cystic lesions. Recognition of their imaging features and embryologic origin is essential for accurate diagnosis and appropriate management.