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Subcutaneous and breast metastasis from asymptomatic gallbladder carcinoma.
[carcinoma of the gallbladder]
Though
gallbladder
carcinoma
is
associated
with
early
lymphatic
and
hematogenous
spread
,
the
only
common
extra
-
abdominal
site
of
metastasis
is
lung
.
Gallbladder
carcinoma
metastasizing
to
breast
and
subcutaneous
tissue
is
not
known
.
This
report
describes
an
interesting
and
unusual
case
of
asymptomatic
gallbladder
carcinoma
presenting
with
subcutaneous
and
breast
metastasis
.
A
42
-
year
-old
woman
presented
with
multiple
subcutaneous
nodules
over
the
abdominal
wall
,
anterior
chest
wall
,
back
and
in
bilateral
breasts
.
Fine
needle
aspiration
cytology
(
FNAC
)
of
these
nodules
revealed
metastatic
adenocarcinoma
.
The
patient
was
investigated
for
a
primary
neoplasm
.
An
ultrasound
of
the
abdomen
followed
by
a
contrast-enhanced
CT
scan
showed
a
growth
in
gallbladder
,
infiltrating
the
liver
with
multiple
hepatic
metastases
.
CT
-guided
FNAC
from
the
growth
in
the
gallbladder
revealed
adenocarcinoma
.
She
was
diagnosed
as
a
case
of
metastatic
adenocarcinoma
of
the
gallbladder
and
palliative
combination
chemotherapy
with
gemcitabine
and
carboplatin
was
given
.
But
she
developed
jaundice
and
deteriorated
dramatically
in
a
short
span
of
time
.
No
specific
therapy
could
be
started
and
she
was
given
supportive
treatment
.
She
died
within
three
weeks
of
diagnosis
due
to
hepatic
encephalopathy
.
This
report
highlights
an
unusual
metastasis
of
gallbladder
carcinoma
to
the
breast
and
subcutaneous
tissue
presenting
as
multiple
lesions
,
which
has
never
been
reported
in
the
English
literature
.
These
were
unknown
sites
of
metastasis
for
carcinoma
of
the
gallbladder
.
Moreover
,
bilateral
multiple
metastatic
lesions
to
breast
are
also
very
rare
.