A Case of Metastatic Breast Carcinoma of the Gallbladder

Daisuke Machida, Norio Yukawa**, Motohiko Gohda, Masahiro Kanari, Atsushi Nagano, Jun Fujisawa, Hiroshi Matsukawa, Satoru Shimizu, Naomi Kawano* and Yasushi Rino**

Department of Surgery and Department of Pathology*, Yokohama Minami Kyosai Hospital
Department of General Surgery, Yokohama City University Hospital**

Metastasis of breast carcinoma to the gallbladder is very rare, with only 9 cases reported in the global literature from 1985 to 2000. A 53-year-old woman admitted for right upper quadrant pain and fever who had been undergone modified radical mastectomy for left breast cancer in 1985, was diagnosed histologically as having papillotubular carcinoma and invasive lobular carcinoma. After the mastectomy, local and bone metastases were treated with chemoradiation and hormonal therapy. In July 2003, abdominal computed tomography and ultrasonography showed a swollen gallbladder with a thickened wall and no stones. We diagnosed the problem as noncalculous cholecystitis and undertook cholecystectomy. Multiple liver metastases were detected intraoperatively and partial hepatic resection was added. Pathological examination of the specimen showed a tumor morphologically identical to the breast carcinoma for which the patient had undergone right mastectomy 18 years earlier.Of the 10 cases, including ours, 5 were diagnosed preoperatively as gallstones or cholecystitis, but none as gallbladder metastases. Six were histologically diagnosed as lobular carcinoma. Careful preoperative abdominal examinations are thus important for cases with a history of breast carcinoma.

Key words
gallbladder metastasis, breast carcinoma, gastrointestinal metastasis

Reprint requests
Daisuke Machida Department of Surgery, Yokohama Minami Kyosai Hospital
1-21-1 Mutsuura-higashi, Kanazawa-ku, Yokohama, 236-0037 JAPAN

Accepted
May 31, 2006

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