# Rokitansky-Aschoff sinus

Source: https://onco.cc/terms/rokitansky-aschoff-sinus/  
OnCo record `rokitansky-aschoff-sinus` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Tiny pouches where the gallbladder lining pushes down into the muscle wall, common in gallbladders damaged by stones and inflammation. They matter in cancer because an early tumour that tracks down into these pouches behaves worse than one that stays on the surface, and mucus trapped in them can be mistaken for cancer under the microscope.

## Summary

Rokitansky-Aschoff sinuses are outpouchings of the gallbladder mucosa into and through the muscularis, frequent in chronic cholecystitis and the basis of adenomyomatosis. In a series of 190 early gallbladder carcinomas (Tis, T1a, T1b) from a high-incidence region, intraepithelial extension into the sinuses was present in 17.8 percent (34 cases); patients with sinus involvement had significantly shorter survival, 39 percent dying of disease against 4 percent without, often late (median 48 months), making it an independent adverse factor for which additional surgery may be considered (Roa 2013). The pitfall runs the other way too: mucin-containing sinuses with extracellular mucin deposits can simulate mucinous carcinoma (Albores-Saavedra 2009), and adenomyomatosis with intramural cysts can be confused with a papillary neoplasm on imaging. The sinuses are why depth measurements in early gallbladder cancer need care and why full sampling of the specimen is advised.

## Fields

- Kind: Term
- Last checked: 2026-09-24
- Also known as: Rokitansky-Aschoff sinuses; RAS; Gallbladder mucosal diverticula; Adenomyomatosis of the gallbladder
- Tags: gallbladder; biliary

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Rokitansky%E2%80%93Aschoff_sinuses
- Roa, Virchows Arch 2013: early gallbladder carcinoma and Rokitansky-Aschoff sinus involvement: https://doi.org/10.1007/s00428-013-1478-1
- Albores-Saavedra, Am J Surg Pathol 2009: mucin-containing Rokitansky-Aschoff sinuses simulating mucinous carcinoma: https://doi.org/10.1097/pas.0b013e3181b63d66

## Connected records

- cancers: [Carcinoma in situ and dysplasia of the gallbladder](https://onco.cc/cancers/gallbladder-carcinoma-in-situ-and-dysplasia/), [Gallbladder cancer](https://onco.cc/cancers/gallbladder/), [Mucinous carcinoma of the gallbladder](https://onco.cc/cancers/gallbladder-mucinous-carcinoma/)
- terms: [Carcinoma in situ (CIS)](https://onco.cc/terms/carcinoma-in-situ/)

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