A resected case of gallbladder metastasis with symptoms of acute cholecystitis in multiple metastatic ductal carcinoma of the breast.
Takeshi UradeShigeteru OkaShinya IimoriMariko Man-ITomoki AbeHidehiro SawaYoshiteru IwataniYukiko MorinagaDaisuke KurodaPublished in: Clinical journal of gastroenterology (2018)
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.
Keyphrases
- estrogen receptor
- liver failure
- lymph node metastasis
- computed tomography
- squamous cell carcinoma
- respiratory failure
- metastatic breast cancer
- small cell lung cancer
- drug induced
- magnetic resonance imaging
- simultaneous determination
- aortic dissection
- contrast enhanced
- intensive care unit
- lymph node
- locally advanced
- liquid chromatography
- young adults
- acute respiratory distress syndrome
- pet ct
- mechanical ventilation