Gallbladder metastasis from occult lobular breast carcinoma: A case report

Abstract

Introduction

Bones, lungs, brain and liver are the most common metastatic sites of breast carcinoma, although invasive lobular carcinoma can give metastases to less common sites, such as gastrointestinal tract and female genital tract.

Case presentation

We present a case of 57-year-old female with colic abdominal pain that was sent to surgery for cholecystectomy. Histopathology revealed poorly cohesive individual or in single file neoplastic cells infiltrating all layers of gallbladder. Immunohistochemistry revealed these cells to be CK 116, CK7, GCDFP-15, ER and PR positive, and CK20, HER-2, S-100 and E-cadherin negative. PET/CT showed numerous lytic bone lesions, but repeated ultrasound and breast MRI, revealed no breast mass.

Conclusion

Although rare and poorly understood, metastases of invasive lobular carcinoma to gallbladder do exist in minor percentage of patients, presenting usually as exacerbated cholecystitis. The problem present silent cases and patients with no history of primary breast carcinoma, as in our presented case.  This case is unique in that even after the diagnosis of metastatic lobular breast carcinoma to gallbladder, primary tumour of the breast was not detected.

Keywords: lobular carcinoma, breast, metastasis, gallbladder