Approach to gallbladder polyps in pediatric patients

Table 1 Risk factors for malignant gallbladder polyps

Risk factor	Description	Evidence and references
Polyp size > 10 mm	Larger polyps have a higher risk of malignancy	In adults, polyps ≥ 10 mm have a 5.9% risk of gallbladder cancer; similar trends were observed in pediatric cases[17]
Sessile morphology	Sessile polyps are more likely to be malignant compared to pedunculated ones	Adult studies show sessile polyps increase malignancy risk by a factor of 7.32[16]
Associated genetic syndromes	Conditions like Peutz–Jeghers syndrome and metachromatic leukodystrophy may increase risk[14,15]	Pediatric cases with these syndromes have been noted to have GBPs with potential for malignancy
Presence of gallstones	Coexistence of gallstones may elevate the risk of malignancy[17]	Some studies suggest an increased risk, though evidence is not conclusive
Age > 50 years	Older age is a known risk factor for gallbladder cancer in adults; relevance in children is unclear[16]	Adult studies indicate increased malignancy risk with age over 50[16]

GBPs: Gallbladder polyps.