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Vats M, Bains L, Lal P, Mandal S. Axillary nodal metastasis of operated gallbladder carcinoma: remote site of aggression-a case report. BMC Surg 2022; 22:16. [PMID: 35033032 PMCID: PMC8761323 DOI: 10.1186/s12893-022-01477-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Gallbladder cancer is a very aggressive type of biliary tract cancer. The only curative treatment is complete surgical excision of the tumour. However, even after surgery, there is still a risk of recurrence of the cancer. CASE PRESENTATION A 63-year-old gentleman presented with the complaint of a non-healing ulcer at upper abdomen for the last 1 month. He had undergone a laparoscopic cholecystectomy at a private centre 4 months ago. Investigations confirmed the diagnosis of epigastric port site metastasis from a primary from gall bladder adenocarcinoma. After undergoing completion radical cholecystectomy with wide local excision of the epigastric ulcer, he received 6 cycles of concurrent chemoradiotherapy. Eighteen months later, he presented to us with bilateral axillary swellings. Investigations confirmed isolated bilateral axillary metastasis and the patient underwent a bilateral axillary lymphadenectomy (Level 3). However, PET scan after 6 months showed widespread metastasis and the patient succumbed to the illness 1 month later. CONCLUSION Axillary metastasis probably occurs due to the presence of microscopic systemic metastasis at the time of development of port site metastasis. An R0 resection of the malignancy is the only viable option for effective therapy. The present case highlights the rare involvement of isolated bilateral axillary lymph nodes as a distant metastatic site with no evidence of disease in the locoregional site. However, the prognosis after metastasis remains dismal despite multiple treatment modalities.
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Affiliation(s)
- Manu Vats
- Department of Surgery, Maulana Azad Medical College, New Delhi, India
| | - Lovenish Bains
- Department of Surgery, Maulana Azad Medical College, New Delhi, India
| | - Pawan Lal
- Department of Surgery, Maulana Azad Medical College, New Delhi, India
| | - Shramana Mandal
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
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Amarti LE, Faouzi H, Salmi N, Ettahri H, Elghissassi I, Mrabti H, Errihani H. Breast metastasis from recurrent gallbladder adenocarcinoma: a case report with review of the literature. J Gastrointest Oncol 2016; 7:E77-80. [PMID: 27512606 DOI: 10.21037/jgo.2016.03.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Gallbladder adenocarcinoma has a poor prognostic. The leading modes of dissemination in gallbladder cancer (GBC) are lymphatic, vascular, neural, intraperitoneal, and intraductal. The most common site of dissemination is liver. Breast metastasis in GBC is an unusual site of dissemination. Only few cases have been reported in the literature. We report a rare case of solitary breast metastasis from recurrent gallbladder carcinoma in light of existing literature.
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Affiliation(s)
- Lamiae El Amarti
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
| | - Houssin Faouzi
- Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco; ; Department of surgery, National Institute of Oncology, Rabat, Morocco
| | - Nariman Salmi
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
| | - Hamza Ettahri
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
| | - Ibrahim Elghissassi
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
| | - Hind Mrabti
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
| | - Hassan Errihani
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco; ; Faculty of Medicine and Pharmacy, Mohammed V University, Souissi, Rabat, Morocco
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Skeletal metastasis in gallbladder cancer from a high-volume tertiary care center of north India: a series of rare occurrence. J Gastrointest Cancer 2015; 46:36-41. [PMID: 25432582 DOI: 10.1007/s12029-014-9666-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE Gallbladder carcinoma is usually characterized by late diagnosis and poor prognosis. Skeletal metastases in gallbladder cancer have been rarely reported in literature. In this study, we evaluated the incidence of skeletal metastasis in gallbladder cancer at our high-volume center and their clinical presentation, radiological imaging, treatment received, outcome, and survival. METHODS Records of all gallbladder carcinoma patients registered in our department from October 2007-October 2012 were retrospectively reviewed to identify gallbladder cancer patients with skeletal metastasis and their data was collected and analyzed. RESULTS Out of 340 cases of gallbladder carcinoma, 189 (55.58 %) were having stage IV disease. Of these, seven (2.1 %) patients had cytologically proven skeletal metastasis. All seven patients had advanced loco-regional abdominal disease with coexistent liver metastasis. Presenting symptoms were predominantly weight loss and back pain with markedly elevated serum alkaline phosphatase (median = 1231 IU/ml). Dorsolumbar vertebral metastasis was the most common site of skeletal metastasis in our series (5/7), followed by pelvic bone (2/7) while skull and sternal metastasis were present in one patient each. All these patients had short median survival (median = 30 days, range = 15-60 days). CONCLUSIONS Incidence of skeletal metastasis in gallbladder cancer is very low (2.1 %). Axial skeleton was the most common site of bone metastasis. Gallbladder cancer with skeletal metastasis portends poor prognosis with rapidly fatal course.
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Mallick S, Roy S, Benson R, Das S, Julka PK, Rath GK. Rare sites of metastasis from gall bladder carcinoma. J Gastrointest Cancer 2014; 46:74-6. [PMID: 25471488 DOI: 10.1007/s12029-014-9674-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Supriya Mallick
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India,
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Solitary breast metastasis from recurrent gallbladder carcinoma simulating a second primary on 18F-FDG PET/CT. Clin Nucl Med 2014; 38:e433-4. [PMID: 24096996 DOI: 10.1097/rlu.0b013e31827088c0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Gallbladder carcinoma is characterized by poor prognosis. It spreads by direct, lymphatic, vascular, neural, intraperitoneal, and intraductal routes. The most commonly involved organ is the liver followed by regional lymph nodes. Extra-abdominal metastases are comparatively rare. We present a case of solitary breast metastasis from recurrent gallbladder carcinoma mimicking a primary breast cancer in (18)F-FDG PET/CT.
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Cardiac metastasis from gallbladder carcinoma. Int J Surg Case Rep 2013; 4:1156-8. [PMID: 24291682 PMCID: PMC3860051 DOI: 10.1016/j.ijscr.2013.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 10/08/2013] [Accepted: 10/15/2013] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Primary gallbladder carcinoma is a rare aggressive neoplasm of elderly with poor prognosis. The tumour is often unresectable at the time of diagnosis. Metastasis to heart is rare and only 6 cases have been reported in the indexed literature. We herein report a case of gallbladder carcinoma metastasizing to heart. PRESENTATION OF CASE A 54 year old female presented with dyspnoea and chest pain with past history of radical cholecystectomy and palliative chemotherapy for adenocarcinoma of gallbladder. Chest X-ray showed cardiomegaly and 2-D ECHO revealed features of tumour deposits on the surface of myocardium and malignant pericardial effusion. Mini-thoracotomy and pericardial window procedure was done to relieve distressing symptoms and biopsy of pericardial tissue revealed metastatic adenocarcinoma. In spite of intensive care, patient succumbed to disease in the post-operative period. DISCUSSION Primary adenocarcinoma of gallbladder is the most common malignancy of biliary tract and fifth most common malignancy of gastro-intestinal system with dismal prognosis. It most commonly spreads to liver and regional lymph nodes, very rarely distant metastasis occurs to kidney, adrenal, thyroid and bones as reported in the literature. Metastasis to heart presents with symptoms of cardiac failure due to pericardial effusion. Even with intensive care patients will invariably succumb to the disease. CONCLUSION Metastatic spread to heart from carcinoma of gallbladder is very rare. Should a patient be suspected of or an operated case of gallbladder carcinoma present with symptoms of congestive heart failure and massive pericardial effusion, cardiac metastasis should be considered.
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Kurniali PC, Kavuturu S, Caliman N, Al-Janadi A. Thyroid metastases from squamous cell carcinoma of gallbladder. J Gastrointest Cancer 2013; 45 Suppl 1:82-4. [PMID: 24126841 DOI: 10.1007/s12029-013-9553-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Peter C Kurniali
- Department of Internal Medicine, Division of Hematology/Oncology, Michigan State University, 401 W Greenlawn Ave, Lansing, MI, 48910, USA,
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Abstract
Gallbladder cancer is a highly fatal disease with poor prognosis; indeed, a high proportion of tumours are diagnosed at an advanced stage. Metastases are commonly detected in regional lymph nodes, liver and peritoneum, but unusual sites of spread such as thyroid and breast have also been described in the literature.We report a case of unsuspected muscle metastases, associated to pulmonary metastases, detected by FDG-PET/CT in a patient with previously removed gallbladder cancer and persistent episodes of haemoptysis.
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Affiliation(s)
- L Gilardi
- Division of Nuclear Medicine, European Institute of Oncology, via Ripamonti 435, 20141 Milano, Italy
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Mountzios G, Bamias A, Dalianis A, Danias P, Pantelidaki E, Nanas J, Dimopoulos M. Endocardial metastases as the only site of relapse in a patient with bladder carcinoma: A case report and review of the literature. Int J Cardiol 2010; 140:e4-7. [PMID: 19046610 DOI: 10.1016/j.ijcard.2008.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Accepted: 11/01/2008] [Indexed: 10/21/2022]
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Jain G, Samaiya A, Mohindra N, Patel K. Bone metastases as the initial presentation of carcinoma of gall bladder: a rarity. Indian J Surg 2009; 71:35-7. [PMID: 23133106 PMCID: PMC3452562 DOI: 10.1007/s12262-009-0008-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2006] [Accepted: 05/15/2008] [Indexed: 10/21/2022] Open
Abstract
Distant metastases are rare form of presentation of carcinoma gall bladder. Bony pain as initial presentation is quite unusual. A 50-year-old woman presented with the pain in right shoulder. Investigation showed metastatic adenocarcinoma in the head of humerus and the primary was found in the gall bladder. She received local radiotherapy for bone metastases and undergoing systemic chemotherapy. Carcinoma gall bladder is a common abdominal malignancy, mostly presenting in advanced stage with abdominal symptoms and obstructive jaundice. In presence of metastasis, the management is palliative and role of chemotherapy is limited for palliation symptoms.
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Affiliation(s)
- Gaurav Jain
- Department of Surgical oncology, Bhopal Memorial Hospital and Research Centre, Bhopal, MP, 462 038 India
| | - Atul Samaiya
- Department of Surgical oncology, Bhopal Memorial Hospital and Research Centre, Bhopal, MP, 462 038 India
| | - Namita Mohindra
- Department of Radiology, Bhopal Memorial Hospital and Research Centre, Bhopal, MP, 462 038 India
| | - Kailash Patel
- Department of Pathology, Bhopal Memorial Hospital and Research Centre, Bhopal, MP, 462 038 India
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Inoue T, Shiraki K, Fuke H, Yamanaka Y, Miyashita K, Ito K, Suzuki M, Sugimoto K, Murata K, Nakano T. Cardiac metastases of gallbladder carcinoma. World J Gastroenterol 2005; 11:2048-9. [PMID: 15801006 PMCID: PMC4305737 DOI: 10.3748/wjg.v11.i13.2048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This report describes the case of a 68-year-old woman diagnosed with advanced gallbladder cancer, whose autopsy revealed multiple metastases, including cardiac metastases.
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Affiliation(s)
- Tomoko Inoue
- Department of Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
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Misra A, Misra S, Chaturvedi A, Srivastava PK. Case report. Orbital metastasis from gall bladder carcinoma. Br J Radiol 2002; 75:72-3. [PMID: 11806962 DOI: 10.1259/bjr.75.889.750072] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Clinical presentation of an extraabdominal metastasis from carcinoma of the gall bladder is rare. Orbital metastasis from gall bladder carcinoma has not been previously reported. We report a case of a 40-year-old woman who developed orbital metastasis from carcinoma of the gall bladder.
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Affiliation(s)
- A Misra
- Department of Ophthalmology, King George's Medical College, Lucknow U.P., India
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