An unusual case of cutaneous metastases from gallbladder cancer

Cutaneous metastasis of gallbladder cancer is an exceedingly infrequent phenomenon. Herein, we report a case of cutaneous metastases of gallbladder carcinoma as a rst clinical manifestation in a 73-year- old woman. Physical examination revealed a violaceous nodule with central ulceration on left upper abdominal wall, ranging in diameter about 3 cm. Biopsy specimen demonstrated middle differentiated carcinoma. Immunohistochemical analysis showed diffuse staining with cytokeratin (CK)-7, CK-19 and carcino-embryonic antigen (CEA). Further computed tomography (CT) and positron emission tomography (PET)/CT scanning con rmed a large occupying lesion in the gallbladder, enlarged lymph nodes in front of the portal vein and behind the common bile duct. The diagnosis of metastatic adenocarcinoma was made. The patient received four-cycle chemotherapy. However, CT scan showed tumor progression with multiple metastatic nodule in lung and subcutaneous nodules. The patient eventually succumbed to the disease less than half a year. As for gallbladder cancer, the skin is an uncommon metastatic site with only a few reported cases. Clinicians should be aware that metastatic cutaneous lesions could be the initial presenting sign for gallbladder cancer.