Acute acalculous cholecystitis due to breast cancer metastasis to the cystic duct

Abstract

BackgroundAcute acalculous cholecystitis (AAC) is a relatively rare disorder of the gallbladder. Breast cancer recurrence more than 10 years after curative surgery is also infrequent.Case presentationHere, we report a case of a 59-year-old woman who presented with right flank pain. Her medical history included a lumpectomy for cancer of the left breast 12 years prior. Laboratory tests showed a severe inflammatory reaction and mild liver function abnormalities. Ultrasonography and computed tomography revealed an enlarged gallbladder and inflammation of the surrounding tissues; however, no gallstone was present. She was diagnosed with AAC. We performed an emergency laparoscopic cholecystectomy, and histopathological examination revealed a poorly differentiated adenocarcinoma in the cystic duct. Both metastatic and primary tumor cells were positive for estrogen and progesterone receptors on immunohistochemistry. The final pathological diagnosis was acute cholecystitis due to breast cancer metastasis to the cystic duct.ConclusionAlthough AAC secondary to metastatic breast cancer is rare, it should be included in the differential diagnosis for abdominal pain in patients with a previous history of breast cancer.

Cystic Duct Metastasis from Renal Cell Carcinoma

“…Two of these cases were cystic duct metastasis from breast cancer. Cholecystectomy was performed for acute acalculous cholecystitis, and a histopathological examination led to an unexpected diagnosis of cystic duct metastasis ( 8 , 9 ). The other case was that of a patient with cystic duct metastasis from rectal cancer that was diagnosed incidentally during surgery for rectal cancer and liver metastasis ( 10 ).…”