Background/Objectives: Mirizzi syndrome (MS) alters biliary anatomy, complicating diagnosis and treatment. We characterized diagnostic pathways in reported cases and compared Csendes type I with types II–V. Methods: PubMed and Scopus were searched through 1 July 2026, supplemented by citation searching. Reports of five or fewer patients were eligible. Patient-level diagnostic, treatment, and outcome data were summarized; groups were compared using Fisher’s exact and Mann–Whitney U tests. Results: We included 133 publications reporting 141 patients. MS was diagnosed preoperatively in 115/138 patients (83.3%). Recognition was more frequent in type I than types II–V (92.5% vs. 76.7%; p = 0.037) and among patients with conventional imaging (94.0% vs. 76.0%; p = 0.014). ERCP use and the number of modalities did not differ by diagnostic status. Compared with type I, types II–V more frequently required bile-duct exploration (37.1% vs. 17.0%), underwent open surgery (43.5% vs. 24.5%), and developed bile leak (24.1% vs. 8.5%) or treatment-related bile-duct injury (24.1% vs. 4.3%). Conclusions: Preoperative recognition was common but less frequent in fistulizing forms. Anatomical classification and conventional imaging may assist operative planning, whereas accumulating modalities showed no diagnostic advantage.

RESUMEN La endoprótesis es una modalidad terapéutica bien aceptada para numerosas enfermedades de la vía biliar. La migración distal es una complicación rara que puede llevar a complicaciones graves. En 1996 se reportó la primera perforación del colon izquierdo secundario a una prótesis biliar plástica, y desde entonces se han reportado cuarenta casos más. Presentamos el caso de una paciente que desarrolló un abdomen agudo trece meses después de la colocación de una endoprótesis. Durante la cirugía se localizó la prótesis a través de un divertículo en el colon sigmoides. Se realizó un cierre primario, con un desenlace clínico adecuado, conveniente evolución y egreso por mejoría, así como un seguimiento externo apropiado.

Background: Fibrolamellar hepatocellular carcinoma (FL‐HCC) is a rare variant of hepatocellular carcinoma (HCC) that typically arises in non‐cirrhotic livers and affects younger individuals compared with conventional HCC. Because patients usually have preserved hepatic function, surgical resection may be feasible even in the presence of large tumors. However, diagnostic uncertainty and concerns regarding extrahepatic disease may limit initial surgical decision‐making. Case Presentation: We report the case of a 48‐year‐old male patient who presented with epigastric discomfort, weight loss, and a palpable abdominal mass. Contrast‐enhanced imaging demonstrated a large hepatic lesion involving segments II, III, and IV, with additional pulmonary and adrenal findings initially raising concern for metastatic disease. The patient had previously been declined surgical treatment at another institution. Further multidisciplinary evaluation, imaging reassessment, and histological confirmation by percutaneous biopsy supported the diagnosis of FL‐HCC without confirmed metastatic disease. An open anatomical left hepatectomy was performed. Histopathology confirmed FL‐HCC with negative surgical margins and no lymph node metastases. Follow‐up 36 months after surgery demonstrated no evidence of recurrence. Conclusion: This case highlights the importance of comprehensive staging and multidisciplinary reassessment in patients with suspected FL‐HCC. Even when surgery has initially been declined, careful evaluation may identify candidates for potentially curative hepatic resection. Long‐term surveillance remains essential due to the risk of recurrence following resection. Additionally, this report illustrates that FL‐HCC can occur outside the typical age range, emphasizing the need to consider this diagnosis in compatible clinical and radiologic contexts.

Porcelain gallbladder (PGB) has historically been considered a premalignant condition, although recent evidence questions the strength of its association with gallbladder carcinoma. Objective: To describe the occurrence and characteristics of malignancy in patients with porcelain gallbladder, as well as clinical, imaging, and surgical characteristics reported in clinal cases. Methods: A systematic review of case reports and case series (≤5 patients) was conducted following PRISMA 2020 guidelines. PubMed/MEDLINE, ScienceDirect, and Redalyc from database inception through March 2026. Individual patient data were extracted including demographic characteristics, imaging findings, calcification pattern, surgical management, histopathology, and outcomes. Descriptive statistics were performed. Results: Fifty-four individual cases of porcelain gallbladder were identified. Patients were predominantly female (70.4%), with ages ranging from 6 to 98 years. Complete calcification was reported in 85.2% of cases. Histopathological confirmation was available in 45 cases (83.3%). Thirteen patients had gallbladder carcinoma associated with porcelain gallbladder, corresponding to 28.9% of those with pathological examinations. Incomplete calcification showed higher frequency of malignancy compared with complete calcification. Mortality was reported in three patients (5.6%), all with malignant disease. Conclusions: The proportion of malignancy observed in published case reports reflects a selected dataset and should not be interpreted as an estimate of population risk. These findings provide descriptive insights into clinical presentations and management patterns, supporting hypothesis generation rather than risk estimation.