Abstract
Gallbladder cancer is often diagnosed with metastasis and is known to have poor prognosis. Although, gallbladder cancer often metastasizes to liver, lung, or lymph nodes, metastasis to gastrointestinal tract is not common. Several autopsy studies reported colorectal metastasis from gallbladder cancer, but most of these cases were supposed to be gastrointestinal invasion from peritoneal dissemination. We experienced a rare case of hematogenous colon metastasis from gallbladder cancer. Colonoscopy for a 76-year-old man who was diagnosed as gallbladder cancer revealed two 5-mm flatly elevated lesions with central erosion in the transverse and sigmoid colon. Endoscopic mucosal resection (EMR) revealed poorly differentiated adenocarcinoma in hematoxylin and eosin staining. Additional immunohistochemistry examination showed strongly positive CK7 expression with negative CDX2, and suggested colon metastases from gallbladder cancer. Despite the positive vertical margin in EMR specimens, autopsy finding denied colorectal invasion from peritoneal dissemination and proved vascular spread colon metastases. Gastrointestinal metastasis is often misdiagnosed as a primary tumor, and thus, it is important to recognize gallbladder cancer as a potential origin of gastrointestinal metastasis.
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References
Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–86.
Hundal R, Shaffer EA. Gallbladder cancer: epidemiology and outcome. Clin Epidemiol. 2014;6:99–109.
Zhu X, Zhang X, Hu X, et al. Survival analysis of patients with primary gallbladder cancer from 2010 to 2015. Medicine. 2020;99:40.
Levy AD, Murkata LA, Rohrmann CA. Gallbladder carcinoma: radiologic-pathologic correlation. Radiographics. 2001;21:295–314.
Sons HU, Borchard F, Joel BS. Carcinoma of the gallbladder: autopsy findings in 287 cases and review of the literature. J Surg Oncol. 1985;28:199–206.
Menuck LS, Amberg JR. Metastatic disease involving the stomach. Am J Dig Dis. 1975;20:903–13.
Haendchen Bento L, Kazuyoshi Minata M, Pires Batista C, et al. Clinical and endoscopic aspects of metastases to the gastrointestinal tract. Endoscopy. 2019;51:646–52.
Gilg MM, Gröchenig HP, Schlemmer A, et al. Secondary tumors of the GI tract: origin, histology, and endoscopic findings. Gastrointest Endosc. 2018;88:151–8.
Pezzuto A, Mariotta S, Fioretti F, et al. Metastasis to the colon from lung cancer presenting with severe hyponatremia and dyspnea in a young male: a case report and review of the literature. Oncol Lett. 2013;5:1477–80.
Lin L, Wang X, Tang C, et al. Clinical characteristics and prognosis of gastrointestinal metastases in solid tumor patients: a retrospective study and review of literatures. Anal Cell Pathol (Amst). 2019;2019:1–7.
Villa Guzman JC, Espinosa J, Cervera R, et al. Gastric and colon metastasis from breast cancer: case report, review of the literature, and possible underlying mechanisms. Breast Cancer (Dove Med Press). 2017;9:1–7.
Lee H, Yang M, Lin K, et al. Metastases from gastric carcinoma to colon in the form of multiple flat elevated lesions: a case report. Kaohsiung J Med Sci. 2004;20:552–7.
Pace U, Contino G, Chiappa A, et al. Metachronous colon metastases from gastric adenocarcinoma: a case report. Case Rep Oncol. 2009;2:92–6.
Cuello AC, Priestley JV, Sofroniew MV. Immunocytochemistry and neurobiology. Q J Exp Physiol. 1983;68:545–78.
Werling RW, Yaziji H, Bacchi CE, et al. CDX2, a highly sensitive and specific marker of adenocarcinomas of intestinal origin. Am J Surg Pathol. 2003;27:303–10.
Kalekou H, Miliaras D. Cytokeratin 7 and 20 expression in Gallbladder carcinoma. Polish J Pathol. 2011;62:25–30.
Duval JV, Savas L, Banner BF. Expression of cytokeratins 7 and 20 in carcinomas of the extrahepatic biliary tract, pancreas, and gallbladder. Arch Pathol Lab Med. 2000;124:1196–200.
Yamada I, Ajiki T, Ueno K, et al. Feasibility of 18F-fluorodeoxyglucose positron-emission tomography for preoperative evaluation of biliary tract cancer. Anticancer Res. 2012;32:5105–10.
Burlina A, Rubin D, Secchiero S, et al. Monitoring skeletal cancer metastases with the bone isoenzyme of tissue unspecific alkaline phosphatase. Clin Chim Acta. 1994;226:151–8.
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Shuichi Tange, Ryunosuke Hakuta, Yousuke Nakai, Hiroki Oyama, Kensaku Noguchi, Yukiko Ito, Yuan Bae, Toshio Kumasaka and Hideo Yoshida declare that they have no conflict of interest.
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Tange, S., Hakuta, R., Nakai, Y. et al. A rare case of gallbladder cancer with multiple metastases to the colon. Clin J Gastroenterol 14, 608–612 (2021). https://doi.org/10.1007/s12328-020-01301-6
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DOI: https://doi.org/10.1007/s12328-020-01301-6