Pyloric Gland Adenoma of the Gallbladder Diagnosed by Endoscopic Ultrasound-Guided Biopsy After Partial Cholecystectomy

Pyloric gland adenoma of the gallbladder is a rare benign lesion with malignant potential, often diagnosed postoperatively due to limited imaging specificity. We present a 67-year-old man with previous partial cholecystectomy found to have a suspicious gallbladder remnant lesion on imaging concerning for malignancy. Endoscopic ultrasound identified a 28.4 × 14 mm intraluminal mass, and fine-needle biopsy via a transduodenal approach confirmed pyloric gland adenoma with low-grade dysplasia. This case highlights the diagnostic utility of endoscopic ultrasound-guided biopsy in gallbladder lesions and emphasizes procedural considerations, including bile leak risk, while aiding surgical planning for lesions with neoplastic potential.