title: Metastatic breast carcinoma initially presenting as acute cholecystitis: a case report and review of the literature.
abstract: BACKGROUND
  The gallbladder is an infrequent site of metastatic malignant disease. Although malignant melanoma, renal cell and cervical carcinoma have been documented, breast carcinoma has rarely been reported to metastasize in the gallbladder.
  
  
  METHODS
  We describe such a case that manifested as acute cholecystitis and was incidentally recognized after cholecystectomy, in an otherwise disease-free 46-year-old female who had undergone mastectomy for breast cancer two years before. The patient was subjected to adjuvant chemotherapy, but unfortunately died just a year after diagnosis because of generalized peritoneal seeding of the tumor.
  
  
  CONCLUSIONS
  Metastatic gallbladder involvement is rare, especially in cases of primary breast carcinoma, usually leading to symptoms of abdominal pain, mimicking acute or chronic cholecystitis. Thus, abdominal pain in a patient with a previous history of breast carcinoma should raise suspicion of gallbladder metastasis.
authors.affiliation: First Department of Propaedeutic Surgery, Hippocrateion Hospital, Athens Medical School, Athens, Greece. amanouras@hippocratio.gr
authors.forename: A
authors.initials: A
authors.lastname: Manouras
authors.forename: E E
authors.initials: EE
authors.lastname: Lagoudianakis
authors.forename: M
authors.initials: M
authors.lastname: Genetzakis
authors.forename: N
authors.initials: N
authors.lastname: Pararas
authors.forename: A
authors.initials: A
authors.lastname: Papadima
authors.forename: P B
authors.initials: PB
authors.lastname: Kekis
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D001943:Breast Neoplasms / Q000556:secondary*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D002764:Cholecystitis / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D005706:Gallbladder Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D006801:Humans; D008875:Middle Aged