IMPLANT METASTASIS OF GALLBLADDER CARCINOMA IN-SITU IN A CHOLECYSTECTOMY SCAR - A CASE-REPORT

A subcutaneous mass within the scar left by cholecystectomy with commo n bile duct exploration and T-tube drainage developed 6 years after su rgery. Pathologic examination of this mass showed features of atypical villous hyperplasia, similar to that identified within the previously removed gallbladder, but with additional foci of carcinoma in situ. S ince excision of the mass, the patient has had persistent fluid collec tions requiring frequent aspiration. Cytologic analysis of the fluid h as revealed tumor cells. The cause of this spread has been unclear. Fe w literature reports have identified biliary drainage techniques as a source for metastatic seeding. The malignant or metastatic potential o f severe dysplasia or carcinoma in situ of the gallbladder associated with T-tube drainage and implantation in the drainage tract is previou sly unreported.