Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not?
Introduction. Abdominal wall masses are a common finding in clinical practice. A high percentage of these masses are malignant. We present the case of a patient operated for a gallbladder adenocarcinoma, who consulted eleven years later for a malignant mass of the abdominal wall in synchrony with tw...
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| Format: | Article |
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Wiley
2021-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2021/6662275 |
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| author | Belén Matías-García Fernando Mendoza-Moreno Manuel Díez-Alonso Ana Quiroga-Valcárcel Elena Aguirregoicoa-García Cristina Vera-Mansilla Enrique Ovejero-Merino Javier Mínguez-García Diego Córdova-García Alberto Gutiérrez-Calvo |
| author_facet | Belén Matías-García Fernando Mendoza-Moreno Manuel Díez-Alonso Ana Quiroga-Valcárcel Elena Aguirregoicoa-García Cristina Vera-Mansilla Enrique Ovejero-Merino Javier Mínguez-García Diego Córdova-García Alberto Gutiérrez-Calvo |
| author_sort | Belén Matías-García |
| collection | DOAJ |
| description | Introduction. Abdominal wall masses are a common finding in clinical practice. A high percentage of these masses are malignant. We present the case of a patient operated for a gallbladder adenocarcinoma, who consulted eleven years later for a malignant mass of the abdominal wall in synchrony with two adenocarcinomas of the left colon and sigmoid. Case Report. A 75-year-old male underwent a laparoscopic cholecystectomy with an incidental diagnosis of adenocarcinoma in situ (TisN0M0 according to AJCC 8th edition). The operative report mentioned that the removal of the gallbladder was difficult due to the inflammatory process, and the gallbladder was accidentally opened during the operation. It was not clear from the operative report whether an extraction bag was utilized to remove the specimen, but the histopathological study confirmed an open gallbladder. He presented 11 years later with an asymptomatic heterogeneous complex cystic mass involving the anterior rectus abdominis muscle. Colonoscopy showed synchronous tumors in the descending and sigmoid colon with pathology confirming adenocarcinoma. The patient underwent an elective laparotomy with resection of the anterior abdominal wall mass, left hemicolectomy, and sigmoidectomy. The histopathological results of the abdominal mass (CK7, CK20, EMA, CEA positive) were described as metastasis of adenocarcinoma of biliary origin. Discussion. Port site recurrences are rare complications following laparoscopic surgery when malignancy is unsuspected. Possible factors related to local implantation include direct seeding of spilled bile or tumor cells into the wound or shedding of tumor cells due to pneumoperitoneum-induced loss of the peritoneal barrier at the trocar site. In the absence of distant metastasis, treatment should include wide port site excision with malignancy-free surgical margins. Conclusion. Abdominal wall metastasis from gallbladder carcinoma is rare, and its synchronous presentation with a malignant neoplasm of the colon is exceptional. This is the first report of a patient with abdominal wall metastasis from a gallbladder adenocarcinoma operated eleven years ago that debuted synchronously with two adenocarcinomas of the left colon and sigma. |
| format | Article |
| id | doaj-art-e75a68cf03fb4aaebed43d85fe22010a |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-e75a68cf03fb4aaebed43d85fe22010a2025-08-20T03:26:10ZengWileyCase Reports in Surgery2090-69002090-69192021-01-01202110.1155/2021/66622756662275Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not?Belén Matías-García0Fernando Mendoza-Moreno1Manuel Díez-Alonso2Ana Quiroga-Valcárcel3Elena Aguirregoicoa-García4Cristina Vera-Mansilla5Enrique Ovejero-Merino6Javier Mínguez-García7Diego Córdova-García8Alberto Gutiérrez-Calvo9Department of General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, Madrid, SpainDepartment of General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, Madrid, SpainDepartment of General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, Madrid, SpainDepartment of General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, Madrid, SpainDepartment of Pathology, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, Madrid, SpainDepartment of General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, Madrid, SpainDepartment of General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, Madrid, SpainDepartment of General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, Madrid, SpainDepartment of General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, Madrid, SpainDepartment of General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcalá de Henares, Madrid, SpainIntroduction. Abdominal wall masses are a common finding in clinical practice. A high percentage of these masses are malignant. We present the case of a patient operated for a gallbladder adenocarcinoma, who consulted eleven years later for a malignant mass of the abdominal wall in synchrony with two adenocarcinomas of the left colon and sigmoid. Case Report. A 75-year-old male underwent a laparoscopic cholecystectomy with an incidental diagnosis of adenocarcinoma in situ (TisN0M0 according to AJCC 8th edition). The operative report mentioned that the removal of the gallbladder was difficult due to the inflammatory process, and the gallbladder was accidentally opened during the operation. It was not clear from the operative report whether an extraction bag was utilized to remove the specimen, but the histopathological study confirmed an open gallbladder. He presented 11 years later with an asymptomatic heterogeneous complex cystic mass involving the anterior rectus abdominis muscle. Colonoscopy showed synchronous tumors in the descending and sigmoid colon with pathology confirming adenocarcinoma. The patient underwent an elective laparotomy with resection of the anterior abdominal wall mass, left hemicolectomy, and sigmoidectomy. The histopathological results of the abdominal mass (CK7, CK20, EMA, CEA positive) were described as metastasis of adenocarcinoma of biliary origin. Discussion. Port site recurrences are rare complications following laparoscopic surgery when malignancy is unsuspected. Possible factors related to local implantation include direct seeding of spilled bile or tumor cells into the wound or shedding of tumor cells due to pneumoperitoneum-induced loss of the peritoneal barrier at the trocar site. In the absence of distant metastasis, treatment should include wide port site excision with malignancy-free surgical margins. Conclusion. Abdominal wall metastasis from gallbladder carcinoma is rare, and its synchronous presentation with a malignant neoplasm of the colon is exceptional. This is the first report of a patient with abdominal wall metastasis from a gallbladder adenocarcinoma operated eleven years ago that debuted synchronously with two adenocarcinomas of the left colon and sigma.http://dx.doi.org/10.1155/2021/6662275 |
| spellingShingle | Belén Matías-García Fernando Mendoza-Moreno Manuel Díez-Alonso Ana Quiroga-Valcárcel Elena Aguirregoicoa-García Cristina Vera-Mansilla Enrique Ovejero-Merino Javier Mínguez-García Diego Córdova-García Alberto Gutiérrez-Calvo Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not? Case Reports in Surgery |
| title | Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not? |
| title_full | Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not? |
| title_fullStr | Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not? |
| title_full_unstemmed | Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not? |
| title_short | Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not? |
| title_sort | unusual case of gallbladder adenocarcinoma metastasis to the abdominal wall 11 years later synchronous presentation with two malignant colon tumors coincidence or not |
| url | http://dx.doi.org/10.1155/2021/6662275 |
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