This 60-year-old lady presented with sudden onset of right sided abdominal pain to our ED. She underwent a CT scan which demonstrated multifocal deposits within the liver and a distended gallbladder with soft tissue mass.
Tumor markers: CA 19-9 5.9, AFP 70, CEA <1.0
The patient underwent a liver biopsy. Histopathology:
- Features consistent with poorly differentiated adenocarcinoma
- Gallbladder adenocarcinoma has no specific immunohistochemistry marker
- Ancillary studies in this case do not suggest any specific tumor type or origin
- Differentials include gallbladder adenocarcinoma, cholangiocarcinoma as well as metastatic adenocarcinoma
Imaging and biopsy findings consistent with metastatic gallbladder adenocarcinoma (stage IV disease).