Simultaneous breast and ovarian metastasis from gallbladder carcinoma.

[carcinoma of the gallbladder]

Gallbladder carcinoma is a common malignancy in the Indian subcontinent . It commonly metastasizes through lymphatics , direct invasion , and hematogenous spread . A common extra -abdominal site of metastasis is the lungs . Simultaneous metastasis to breast and ovary is extremely rare .This report describes an unusual case of carcinoma gallbladder metastasizing to the breast and ovary at the same time .A 45 -year -old woman came to us with complaints of flatulent dyspepsia associated with weight loss and anorexia . Ultrasound of the abdomen revealed hepatomegaly with thick -walled gallbladder with multiple stones and a mass at the fundus , but normal uterus and ovary . Contrast-enhanced computer tomography of the abdomen showed a gallbladder mass infiltrating the liver parenchyma . The patient underwent radical cholecystectomy . Histopathological examination revealed a poorly -differentiated adenocarcinoma with mar-gins free from tumor infiltration . One month after surgery she developed a breast lump . Ultrasound of the abdomen for metastatic workup revealed an ovary mass . Simple mastectomy and salphingo-opherectomy were performed , and histopathological examination revealed a metastatic adenocarcinoma . The patient is now on chemotherapy with gemcitabin .This is an unusual case of carcinoma of the gallbladder with metastasis to the breast and ovary , which has not been documented before .