PRIMARY ADENOCARCINOMA OF THE GALLBLADDER PRESENTING AS PRIMARY GYNECOLOGIC MALIGNANCY - A REPORT OF 2 CASES

Background: Carcinoma metastatic to the uterus from extragenital sites is rare. Such metastatic disease is typically diagnosed at autopsy or in patients with known primary malignancies. This report discusses tw o cases of primary carcinoma of the gallbladder presenting as abnormal ities in gynecologic screening procedures. Cases: A 71-year-old woman presented with postmenopausal bleeding. Uterine curettage revealed poo rly differentiated adenocarcinoma of presumed endometrial origin. Intr aoperative frozen-section analysis of the uterus showed carcinoma invo lving the lymphatics, but no primary tumor. further exploration reveal ed primary adenocarcinoma of the gallbladder, with widespread metastas es. The second case was a 67-year-old asymptomatic woman. Routine cerv ical cytology showed adenocarcinoma, but tissue studies were negative. She developed jaundice 1 month later. Computed tomography of the uppe r abdomen revealed a mass in the gallbladder fossa, and needle biopsy of the lesion showed adenocarcinoma. Conclusions: Metastatic carcinoma of non-genital tract origin may present as primary gynecologic malign ancy. The physician should be aware of the implications of both the co mmon and unusual interpretations of screening and diagnostic procedure s. When the clinicopathologic presentation is atypical, a thorough kno wledge of the differential diagnoses of abnormal test results allows a ppropriate and expeditious patient management.