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Sugita H, Sato R, Araki T, Okuda T, Miyanaga T, Doden K. Acute acalculous cholecystitis caused by gallbladder metastasis due to the peritoneal dissemination of gastric cancer: A case report. Int J Surg Case Rep 2021; 81:105764. [PMID: 33743255 PMCID: PMC8010458 DOI: 10.1016/j.ijscr.2021.105764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 11/17/2022] Open
Abstract
Acute acalculous cholecystitis is rare, but life threatening disease. Metastasis to the gallbladder is infrequent. Acute acalculous cholecystitis caused by peritoneal dissemination of gastric cancer is rare and immediate treatment is essential.
Introduction and importance Acute acalculous cholecystitis (AAC) is associated with a high mortality rate. AAC caused by metastasis to the gallbladder is rare. We report a case of AAC caused by gallbladder metastasis due to the peritoneal dissemination of gastric cancer. Case presentation An 84-year-old male visited our hospital because of epigastric pain. Ultrasonography and computed tomography revealed swelling and thickening of the gallbladder wall, but stones were not observed in the gallbladder. We performed emergency surgery with a diagnosis of acute cholecystitis. Laparoscopy revealed the presence of many nodules around the abdominal cavity including the hepatoduodenal ligament. Inflammation of Calot’s triangle was severe, so we performed subtotal cholecystectomy. We also resected one of the peritoneal nodules. Macroscopically, there were no stones in the gallbladder and histopathological examination revealed acute cholecystitis and existence of adenocarcinoma involving the subserosa of the gallbladder wall and the resected peritoneal nodule. After surgery, esophagogastroduodenoscopy revealed Borrmann type II lesions at the antrum and gastric biopsy showed adenocarcinoma. He was diagnosed with advanced gastric cancer with peritoneal dissemination. His postoperative course was good. Clinical discussion The cases of AAC caused by gallbladder metastasis have been little reported in the literature. This case is advanced gastric cancer with peritoneal dissemination and AAC was thought to be caused by peritoneal dissemination from operative and histopathological findings. We successfully treated this rare case of AAC with laparoscopic surgery. Conclusion Although metastasis to the gallbladder is rare, it is necessary to be aware of this possibility when treating AAC.
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Affiliation(s)
- Hiroaki Sugita
- Department of Surgery, Fukui Prefectural Hospital, 2-8-1, Yotsui, Fukui, Fukui, 910-8526, Japan.
| | - Risa Sato
- Department of Surgery, Fukui Prefectural Hospital, 2-8-1, Yotsui, Fukui, Fukui, 910-8526, Japan
| | - Takahiro Araki
- Department of Surgery, Fukui Prefectural Hospital, 2-8-1, Yotsui, Fukui, Fukui, 910-8526, Japan
| | - Toshiyuki Okuda
- Department of Surgery, Fukui Prefectural Hospital, 2-8-1, Yotsui, Fukui, Fukui, 910-8526, Japan
| | - Tamon Miyanaga
- Department of Surgery, Fukui Prefectural Hospital, 2-8-1, Yotsui, Fukui, Fukui, 910-8526, Japan
| | - Kenji Doden
- Department of Surgery, Fukui Prefectural Hospital, 2-8-1, Yotsui, Fukui, Fukui, 910-8526, Japan
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Missori G, Serra F, Prestigiacomo G, Ricciardolo AA, Brugioni L, Gelmini R. Case Report: Metastatic breast cancer to the gallbladder. F1000Res 2020; 9:343. [PMID: 33204409 PMCID: PMC7610173 DOI: 10.12688/f1000research.23469.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2020] [Indexed: 12/17/2022] Open
Abstract
Cholecystitis is one of the leading causes of emergency surgical interventions; the occurrence of metastases to the gallbladder is rare and has only been reported in the literature exceptionally. Metastatic breast cancer to the gallbladder is even less frequent; in fact, breast cancer usually metastasizes to bone, lung, lymph nodes, liver and brain. We report the case of an 83-year-old female patient with a previous history of breast surgery with axillary dissection in 1997, followed by adjuvant chemotherapy due to invasive ductal carcinoma of the left breast. The patient was admitted at the emergency department for sepsis and an episode of acute kidney failure, anuria and fever. Right-upper quadrant abdominal pain triggered by food intake and abdominal tenderness was also present, placing the diagnostic suspicion of biliary sepsis due to acute cholecystitis. The histological examination of the surgical specimen highlighted the presence of metastasis from an infiltrating ductal breast carcinoma with positive hormone receptors. We also report here the results of a review of the literature looking at articles describing cases of gallbladder metastasis from breast cancer.
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Affiliation(s)
- Giulia Missori
- Department of General Surgery, University of Modena and Reggio Emilia, Modena, Italy, 41124, Italy
| | - Francesco Serra
- Department of General Surgery, University of Modena and Reggio Emilia, Modena, Italy, 41124, Italy
| | - Giorgia Prestigiacomo
- Department of General Surgery, University of Modena and Reggio Emilia, Modena, Italy, 41124, Italy
| | | | - Lucio Brugioni
- Department of Emergency Medicine, University Hospital Modena, Modena, Italy, 41124, Italy
| | - Roberta Gelmini
- Department of General Surgery, University of Modena and Reggio Emilia, Modena, Italy, 41124, Italy
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Ueda J, Makino H, Yokoyama T, Maruyama H, Hirakata A, Takata H, Seki N, Kikuchi Y, Yoshioka M, Irie T, Yoshida H. Rare Case of Synchronous Cystic Duct Metastasis from Renal Cell Carcinoma. J NIPPON MED SCH 2019; 86:242-247. [PMID: 31061254 DOI: 10.1272/jnms.jnms.2018_86-405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The common metastatic sites of renal cell cancer (RCC) are the lung, bone, liver, brain, adrenal glands, and contralateral kidney. Metastasis to the gallbladder is rare, and cystic duct metastasis from RCC has been reported in only one metachronous case. This is the first report of a case of synchronous cystic duct metastasis from RCC. CASE REPORT A 72-year-old woman presenting with hematuria had a history of Cushing disease approximately 10 years previously. Enhanced computed tomography of the abdomen showed a mass measuring 5.8 × 3.0 cm in the left kidney, which was strongly enhanced in the early phase and washed out in the late phase. A mass measuring 2 cm in diameter was seen in the left adrenal gland, and a 1.0-cm mass was noted in the right adrenal gland. Multiple tiny masses were detected in the cystic duct. Left renal cell carcinoma, cystic duct metastasis, and bilateral adrenal gland metastases were diagnosed. Because the metastatic tumor was close to the common bile duct, we performed left nephrectomy, bilateral adrenalectomy, cholecystectomy, resection of the extrahepatic bile duct, and hepaticojejunostomy. Pathological findings showed that the renal tumor was clear cell carcinoma, as were the bilateral adrenal tumors and cystic duct tumor. The patient died 30 months after the operation.
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Affiliation(s)
- Junji Ueda
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Hiroshi Makino
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Tadashi Yokoyama
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Hiroshi Maruyama
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Atsushi Hirakata
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Hideyuki Takata
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Natsuki Seki
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Yuta Kikuchi
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | | | - Toshiyuki Irie
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
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Urade T, Oka S, Iimori S, Man-I M, Abe T, Sawa H, Iwatani Y, Morinaga Y, Kuroda D. A resected case of gallbladder metastasis with symptoms of acute cholecystitis in multiple metastatic ductal carcinoma of the breast. Clin J Gastroenterol 2018; 12:52-56. [PMID: 30109570 DOI: 10.1007/s12328-018-0892-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/06/2018] [Indexed: 11/26/2022]
Abstract
Gallbladder metastasis from breast cancer, especially from ductal carcinoma, is rare. Herein, we report a rare case of gallbladder metastasis from ductal carcinoma of the breast that was diagnosed after laparoscopic cholecystectomy (LC) for acute cholecystitis. A 78-year-old woman presented with right upper abdominal tenderness and positive Murphy's sign during chemotherapy for advanced multiple metastases of the breast cancer. Abdominal ultrasonography and computed tomography showed a slightly thickened gallbladder wall and two calculi. After a diagnosis of acute calculous cholecystitis was established, LC was performed. Pathological examination revealed poorly differentiated adenocarcinoma infiltrating the submucosal and subserosal layer over the entire gallbladder, and a lymph node metastasis in the gallbladder neck. Immunohistochemical examination revealed that the tumor cells tested positive for estrogen receptor and negative for progesterone receptor, which was consistent with primary breast cancer. The patient was uneventfully discharged without abdominal pain 7 days later. Although she subsequently underwent several chemotherapies, she died 16 months later. In conclusion, gallbladder metastasis should be considered in patients with multiple metastatic breast cancer who present with signs or symptoms of cholecystitis. Moreover, LC should be considered to relieve the symptoms of cholecystitis for improved prognosis, even in a patient with multiple metastases.
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Affiliation(s)
- Takeshi Urade
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan.
| | - Shigeteru Oka
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Shinya Iimori
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Mariko Man-I
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Tomoki Abe
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Hidehiro Sawa
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Yoshiteru Iwatani
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Yukiko Morinaga
- Department of Diagnostic Pathology, Kita-Harima Medical Center, Ono, Japan
| | - Daisuke Kuroda
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
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Koga H, Yane K, Maguchi H, Takahashi K, Katanuma A, Kin T, Ambo Y, Omori Y, Shinohara T. Cystic Duct Metastasis from Renal Cell Carcinoma. Intern Med 2018; 57:213-218. [PMID: 29093406 PMCID: PMC5820039 DOI: 10.2169/internalmedicine.9228-17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
We herein report a 69-year-old man who underwent right nephrectomy 1 year previously to remove renal cell carcinoma (RCC). On our examinations, contrast-enhanced computed tomography revealed a tumor with intensive early enhancement near the cystic duct of the gallbladder. Endoscopic ultrasonography showed a low echoic mass in the cystic duct. We diagnosed the patient's condition as cystic duct metastasis from RCC and performed open cholecystectomy. Histopathology indicated a metastatic tumor of clear cell RCC in the cystic duct wall. In patients with a medical history of RCC, hypervascular lesions suggest the possibility of metastasis. Therefore, detailed imaging examinations should be performed.
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Affiliation(s)
- Hideaki Koga
- Center for Gastroenterology, Teine-Keijinkai Hospital, Japan
| | - Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Japan
| | | | | | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Japan
| | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Japan
| | | | - Yuko Omori
- Department of Pathology, Teine-Keijinkai Hospital, Japan
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