Metastasis of the gallbladder from the breast cancer
- PMID: 25707544
Metastasis of the gallbladder from the breast cancer
Abstract
Aim: Metastatic lesions of the gallbladder are an infrequent clinical condition. The metastatic lesions of gallbladder from primary breast tumors are rarely described in literature.
Material of study: We report a case of an 83-year-old woman who underwent cholecystectomy for cholelithiasis by video laparoscopy (VL), and in whom a metastatic lesion was detected at the histological examination of surgical specimen. For this reason, the patient was subjected to diagnostic-instrumental investigation with the aim of detecting the primary tumor, which showed the presence of infiltrating lobular carcinoma, pleomorphic variety, in the upper outer quadrant of the right breast.
Discussion: Breast cancer and in particular the histological type "ductal infiltrating" is frequently associated with locoregional and distant metastases, the latter especially to bones, liver, lungs and central nervous system. An analysis of literature was conducted on secondary lesions of the gallbladder from breast cancer that has allowed us to confirm the rarity of this disease only described in 18 patients: 12 from infiltrating lobular, 1 ductal origin and 2 mixed ductal and lobular infiltrating.
Conclusions: The most frequent tumor histology associated with the above-mentioned metastatic localization is the metastatic infiltrating lobular carcinoma. Clinically speaking, it is difficult to suspect a metastatic localization from primary breast cancer in the gallbladder, but it is necessary to be well aware of the possibility of metastasis and to bear this in mind during the follow-up of patients with breast cancer. Although cholecystectomy is regarded as a palliative treatment in patients with metastasis in the gallbladder from breast cancer, it is intead recommended in symptomatic cases.
Le lesioni metastatiche della colecisti costituiscono una condizione clinica non frequente. Nella maggior parte dei casi si tratta di metastasi da melanoma, da tumore renale e da tumori della cervice. Lesioni metastatiche colecistiche da tumore primitivo della mammella sono descritte raramente in letteratura. In questa nota viene presentato il caso di una donna di 83 anni, sottoposta ad intervento chirurgico di colecistectomia videolaparoscopica (VL) per colelitiasi, con riscontro all’esame istologico del pezzo operatorio di una lesione di tipo metastatico Il carcinoma della mammella ed in particolare la varietà istologica duttale infiltrante si associa con elevata frequenza a metastasi loco-regionali e a distanza, quest’ultime a carico di ossa, fegato, polmone e SNC. Lesioni metastatiche a carico del tratto gastrointestinale, del peritoneo, del retroperitoneo e della pelvi possono essere causate soprattutto dal carcinoma lobulare invasivo, variante istologica meno frequente rispetto al tumore duttale rappresentando circa il 10% di tutti i carcinomi mammari. In questa nota è stata condotta una analisi dei dati della Letteratura sulle lesioni secondarie della colecisti da carcinoma della mammella che ha permesso di confermare la rarità di tale patologia descritta solamente in 18 pazienti: 12 di origine lobulare infiltrante, 1 di origine duttale e 2 misto duttale e lobulare infiltrante. La prognosi del carcinoma mammario metastatico è considerato incerto e spesso infausto. Clinicamente è difficile sospettare una localizzazione metastatica da carcinoma mammario primario nella colecisti, ma riteniamo che sia necessario conoscere bene questa possibilità di metastasi e da tenere a mente durante il follow-up di pazienti con cancro al seno. Sebbene la colecistectomia sia considerata come trattamento palliativo nelle pazienti con metastasi alla colecisti da carcinoma mammario, è consigliabile nei casi sintomatici.
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