title: Gallbladder metastases from ductal papillary carcinoma of the breast.
abstract: Breast cancer occurs primarily in women aged 25 years or older. Breast carcinoma has the potential for widespread dissemination, such as metastasis to axillary lymph nodes, bone, lung, pleura, brain, and soft tissues. Liver, gastrointestinal, and biliary tract involvement are infrequent. We report a patient, a 62-year-old woman, with symptomatic cholelithiasis. The patient proceeded to laparoscopic cholecystectomy. She had a previous history of mastectomy with axillary lymphadenectomy, performed for a breast ductal papillary carcinoma, 10 years prior to the cholecystectomy. The gallbladder was hydropic; the wall was thickened, with a focal broad-based lesion on the mesenteric face of the body. Histopathological evaluation of the focal broad-based lesion of the gallbladder revealed poorly differentiated adenocarcinoma infiltration, without mucosal involvement. Subsequent immunohistochemical examination showed the lesion to be cytokeratin 7(CK7)-positive and cytokeratin 20 (CK20)-negative. Estrogen receptor (ER) and progesterone receptor (PgR) were positive. The final pathological diagnosis was breast ductal papillary carcinoma metastases to the gallbladder. Mammography of the other breast was normal. Computed tomography (CT) scan of the brain, chest, abdomen, and pelvis was performed, without any pathological findings. Bone Tc-99 scintigraphy was normal. Six months after the surgery positron emission tomography (PET) showed no evidence of metastatic disease. Two years after the surgery, the patient died, in the absence of recurrence. A literature review revealed only a few more cases of metastasic breast carcinoma to the gallbladder.
authors.affiliation: Department of Surgery, Section of Hepato Pancreato Biliary Surgery, Bernardo A. Houssay Hospital, Hipolito Yrigoyen 1757, Florida, B1602BPD, Buenos Aires, Argentina.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Murguia
authors.forename: Daniel
authors.initials: D
authors.lastname: Quiroga
authors.forename: Geraldine
authors.initials: G
authors.lastname: Canteros
authors.forename: Cesar
authors.initials: C
authors.lastname: Sanmartino
authors.forename: Mariano
authors.initials: M
authors.lastname: Barreiro
authors.forename: Jose
authors.initials: J
authors.lastname: Herrera
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery; D002763:Cholecystectomy; D017809:Fatal Outcome; D005260:Female; D005706:Gallbladder Neoplasms / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged