title: Bone metastases as the initial presentation of carcinoma of gall bladder: a rarity.
abstract: Distant metastases are rare form of presentation of carcinoma gall bladder. Bony pain as initial presentation is quite unusual. A 50-year-old woman presented with the pain in right shoulder. Investigation showed metastatic adenocarcinoma in the head of humerus and the primary was found in the gall bladder. She received local radiotherapy for bone metastases and undergoing systemic chemotherapy. Carcinoma gall bladder is a common abdominal malignancy, mostly presenting in advanced stage with abdominal symptoms and obstructive jaundice. In presence of metastasis, the management is palliative and role of chemotherapy is limited for palliation symptoms.
authors.affiliation: Department of Surgical oncology, Bhopal Memorial Hospital and Research Centre, Bhopal, MP, 462 038 India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Jain
authors.forename: Atul
authors.initials: A
authors.lastname: Samaiya
authors.forename: Namita
authors.initials: N
authors.lastname: Mohindra
authors.forename: Kailash
authors.initials: K
authors.lastname: Patel
keywords: Bone metastases; Carcinoma gall bladder; Chemotherapy