Uninvited Guest in the H ouse: A Rare Case of Metastatic Gallbladder Cancer

Abstract

Gallbladder cancer is a rare malignancy. About 1–2% of surgical specimens demonstrated a gallbladder cancer as an incidental finding. Metastasis to ovaries by biliary origin, known as Krukenberg tumour, though known, is infrequent. It can mimic clinically and morphologically, as a primary ovarian tumour challenging the diagnosis. Diagnosis of secondary ovarian tumours though its challenging often misdiagnosed as primary ovarian cancer, specifically mucinous adenocarcinomas. The distinction from the latter is essential, as it requires different treatment. Immunohistochemistry plays an important role in distinguishing primary ovarian tumours from extra-ovarian metastases. Detailed diagnostic laparotomy with examination of upper abdomen , IHC and UGI scopy evaluation plays a major role in identifying the primary tumour and make the correct diagnosis. As treatment varies according to primary, detailed evaluation might help in deciding appropriate palliative chemotherapy. Keywords: Krukenberg tumour, Gall bladder cancer, Immunohistochemistry, UGI scopy, Metastatic gallbladder cancer, Ovarian metastasis, Ovarian mass