Metastatic breast cancer mimicking a hilar cholangiocarcinoma: case report and review of the literature (original) (raw)
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Case Report: Metastatic breast cancer to the gallbladder
F1000Research, 2020
Cholecystitis is one of the leading causes of emergency surgical interventions; the occurrence of metastases to the gallbladder is rare and has only been reported in the literature exceptionally. Metastatic breast cancer to the gallbladder is even less frequent; in fact, breast cancer usually metastasizes to bone, lung, lymph nodes, liver and brain. We report the case of an 83-year-old female patient with a previous history of breast surgery with axillary dissection in 1997, followed by adjuvant chemotherapy due to invasive ductal carcinoma of the left breast. The patient was admitted at the emergency department for sepsis and an episode of acute kidney failure, anuria and fever. Right-upper quadrant abdominal pain triggered by food intake and abdominal tenderness was also present, placing the diagnostic suspicion of biliary sepsis due to acute cholecystitis. The histological examination of the surgical specimen highlighted the presence of metastasis from an infiltrating ductal breast carcinoma with positive hormone receptors. We also report here the results of a review of the literature looking at articles describing cases of gallbladder metastasis from breast cancer.
Breast carcinoma with asymptomatic metastasis to the gallbladder
Singapore medical journal, 2012
The biliary tract is an unusual site of metastasis from breast carcinoma, and this has rarely been reported in the literature. We report the case of a 42-year-old woman diagnosed with invasive lobular carcinoma of the breast who underwent laparoscopic cholecystectomy for an incidental finding of gallbladder wall thickening on ultrasonography, which was subsequently confirmed to be consistent with metastasis from the breast primary.
Cancer of the extrahepatic bile ducts
Medical and …, 1980
Case histories of 47 patients with histologically confirmed carcinoma of extrahepatic bile ducts presenting to M. D. Anderson Hospital and Tumor Institute over a 30-year period were studied. The disease was more common in males during the sixth and seventh decades of life. A third of the patients had history of cholelithiasis. Four patients had prior history of chronic ulcerative colitis and one patient had congenital choledochal cyst prior to development of cancer of the bile duct. Jaundice was the earliest and the most common presenting sign. The tumor was located in the common bile duct more often than in the hepatic ducts. The overall median survival was eight months with two-year and five-year survival rates of 15% and 3%, respectively. The respective values for patients who had resectable tumors were 21.7 months, 57% and 20%. Ascending cholangitis was a frequent complication in patients treated with dilation and intubation and, overall, hepatic failure and systemic infection were more frequent causes of death than distant metastases.
A Biliary Recurrence of a Breast Cancer: Case Report and Review of the Literature
Journal of Cancer Therapy, 2017
A 51-year-old female with a history of radical mastectomy with axillary lymph node dissection, adjuvant chemotherapy and radiation for a breast cancer was referred to the emergency room due to cholangitis. A CT scan showed a common bile duct mass invading the duodenum. After bile draining, the investigations led to an undifferentiated carcinoma with positive hormonal receptors. The diagnosis of a breast cancer recurrence was established and the patient was commenced on taxane therapy.
International Journal of Women's Health
Liver metastases are secondary malignant tumor formations due to the dissemination of primary malignant tumors, which are often the first clinical manifestation of mammary cancer. We present the case of a 52-year-old female patient from an urban area who came to the walk-in service at the "Sf. Ap. Andrei" Emergency County Hospital, Galati, for laboratory investigations. These revealed a significant increase in CA 15-3 tumor markers and a slight increase in CA 125 and CA 19-9 markers; however, clinical examination did not reveal tumors in the breast and there were no axillary adenopathies. CT exam revealed a large tumor formation in the hepatic right lobe and, close to it, a smaller one. The mammograph showed millimetric lesions at the level of the left mammary gland and bilateral axillary adenopathies. Subsequently, the patient underwent two liver biopsies in two different hospitals, which produced different histological and immunohistochemical results. PET-CT drew attention to a lung tumor and disclosed a different origin of metastases. In the end, correlating all investigations, the final diagnosis was cholangiocarcinoma with liver metastases and lung tumor with lung and bone metastases.
Journal of gastrointestinal oncology, 2016
Cholangiocarcinoma (CCA) is a rare cancer of the biliary epithelium comprising only about 3% of all gastrointestinal malignancies. It is a highly aggressive malignancy and confers a dismal prognosis with majority of patients presenting with metastatic disease. Metastatic CCA to the colon is extremely rare with only few cases reported in the literature. We present a 61-year-old patient with incidental synchronous metastatic colonic adenocarcinoma from extra-hepatic CCA. Laboratory data revealed significant indirect hyperbilirubinemia and transaminitis. Imaging study showed intrahepatic bile ducts prominence without mass lesions. Incidentally, there was diffuse colonic thickening without mass lesions or obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) showed a common bile duct stricture. Brushings were consistent with CCA. Screening colonoscopy identified nodularity and biopsy and immunostaining were consistent with CCA metastasis to colon. The patient elected for pa...
Ampullary Metastasis From Breast Cancer: A Rare Cause of Obstructive Jaundice
GE Portuguese Journal of Gastroenterology, 2016
Breast cancer is the most common tumor in women and the first cause of death for malignancy in the female. Bile ducts are not among the common sites of metastasis from breast cancer. Few cases of obstructive jaundice due to metastatic breast cancer have been described in the literature and they mostly resulted from widespread liver metastases that eventually involved the bile ducts. We report an exceptional case of ampullary metastasis in the absence of liver metastases. Sporadic reports have been published about the involvement of the ampulla by breast cancer metastasis. This case emphasizes the need to consider this diagnosis in women presenting with obstructive jaundice, especially when there is a clinical possibility of breast cancer.
Imaging Diagnosis of Metastases to Breast: A Rare Presentation of Carcinoma Gallbladder
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2017
A 45-year-old post-menopausal female, resident of North India, presented with an ulcero-proliferative mass in the epigastric region accompanied by multiple masses in both breasts for the past one year [Table/Fig-1]. On examination, the epigastric ulcero-proliferative mass was seen to extend into the midline chest wall and the right breast. Additionally, multiple nodules of firm consistency were palpable in the skin and subcutaneous tissue of both breasts. On persistent enquiry, the patient submitted a history of laparoscopic cholecystectomy for cholelithiasis, performed two years earlier at some other hospital. However, the previous relevant medical records were not available. The clinical team suspected occult primary malignancy with metastasis. A prompt routine laboratory and radiological evaluation was resquisitioned which included ultrasound of both breasts, CT study of thorax and abdomen. Laboratory parameters were found to be within normal limits. Ultrasound of both breasts revealed multiple well-circumscribed hypoechoic