title: Metastatic gallbladder adenosquamous carcinoma to the skin†.
abstract: Cutaneous metastasis (CM) is an uncommon manifestation of visceral malignancies. Adenosquamous carcinoma of the gallbladder is a rare variation in gallbladder carcinoma (GBC), associated with worse prognosis. We present the case of a 56-year-old woman who presented with an inflamed lump on her abdominal wall. Computed tomography (CT) revealed a large mass from the gallbladder invading the abdominal wall. She underwent liver resection with regional lymphadenectomy. Pathology analysis revealed a 12-cm pT3N0 GBC. Hospital discharge occurred at post-operative Day 20. She recurred and died 10 months after surgery. Survival after the diagnosis of CM is dismal. The present case was a diagnostic trap. First, the patient's skin lesion presented as a cutaneous abscess and biopsy revealed a squamous cell cancer. A CT scan suggested a continuous mass involving the abdominal wall. CM was only suspected during surgery when no continuity between the tumour and the abdominal wall was identified.
authors.affiliation: Service de chirurgie digestive, viscérale et endocrinienne, Groupe Hospitalier Diaconesses Croix-Saint-Simon, Paris, France Department of Gastroenterology, University of São Paulo Medical School, São Paulo, Brazil rmlupinacci@gmail.com.
authors.forename: Renato Micelli
authors.initials: RM
authors.lastname: Lupinacci
authors.affiliation: Serviço de Cirurgie Geral e Oncologica, Hospital do Servidor Publico Estadual, São Paulo, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Santana
authors.affiliation: Department of Gastroenterology, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: André Roncon
authors.initials: AR
authors.lastname: Dias