Metastasis of Gall Bladder carcinoma - A case Report

Abstract

Metastasis of Gall Bladder Carcinoma (GBC) is very uncommon, aggressive and fatal cancer. World wide incidence rate reported as <2/100000 of all Gastrointestinal tumours. More frequent in women than men, older age more affected and coexisting Gall stonesare seen in majority cases. Because of vague symptoms at early stage tumour will not be encountered, most of the patients present in advanced stage, soprognosis is poor, hence Metastasis of GBC forms a diagnostic and therapeutic challenge. Case Report: A 53 years old male, known diabetic past 10 years presented with intermittent vague symptoms of vomiting, nausea, fever, fatigue, right upper quadrant pain since 3 months. Family history of Gallstones and cancer was present. On examination 2-3 bilateral cervical swellings present, abdominal examination reveals liver was palpable 4 cms below the right costal margin. Relevant investigations done.Complete blood count & Liver function tests were abnormal. Ultrasonography (USG) of abdomen and pelvis, USG guided FNAC of liver, CT of abdomen and pelvis, PET scan of abdomen, Histopathological and Immunohistochemistry report of left supraclavicularlymphnode biopsy were suggestive of metastatic adenocarcinoma of GB origin. After appropriate staging adjuvant chemotherapy started, after third chemotherapy cycle he died of due to metastasis of GBC, two months from his initial diagnosis. Conclusion:In the present study patient was diagnosed in advanced stage, early diagnosis could be missed due to vague symptoms and as GBC is uncommon entity, So proper evaluation of the patient in early stage may prolong the survival.