title: Postmenopausal bleeding and vaginal nodules as the first presenting sign of adenocarcinoma of the gallbladder.
abstract: Vaginal submucosal nodules were observed in a 67-year-old woman, with ultrasonographic features of an advanced uterine neoplasm. On biopsy, light microscopy suggested that the lesions might be metastatic foci from an extragenital cancer, with a prevalent tubular growth pattern. Parallel immunohistochemical reactions revealed a diffuse, strong CA 19-9 positivity in both the cell membrane and cytoplasm. Subsequently, high serum levels of such tumor marker were also found, and an extragenital cancer was suspected of pancreatic or biliary origin. A mass in the gallbladder fossa was then detected by computed tomography and a primary gallbladder adenocarcinoma was confirmed on ultrasound-guided biopsy.
authors.affiliation: Department of Gynecological, Obstetrical Sciences and Reproductiove Medicine, University Hospital, Messina, Italy.
authors.forename: O
authors.initials: O
authors.lastname: Triolo
authors.forename: F
authors.initials: F
authors.lastname: Antico
authors.forename: A
authors.initials: A
authors.lastname: Mancuso
authors.forename: V
authors.initials: V
authors.lastname: Salimbeni
authors.forename: P A
authors.initials: PA
authors.lastname: Nicotina
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000556:secondary; D000368:Aged; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D009362:Neoplasm Metastasis; D017698:Postmenopause; D014592:Uterine Hemorrhage / Q000209:etiology; D014594:Uterine Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000556:secondary; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000556:secondary