Occult gallbladder carcinoma presenting as a primary ovarian tumor in two women: two case reports and a review of the literature

J Med Case Rep. 2010 Jun 30:4:202. doi: 10.1186/1752-1947-4-202.

Abstract

Introduction: The ovary is a common site of metastasis from various organs. However, little is known about gallbladder carcinoma metastasizing to the ovaries and presenting as a primary ovarian tumor.

Case presentation: We report two cases of a metastatic gallbladder carcinoma which mimicked a primary ovarian tumor in a 35-year-old and a 62-year-old North Indian woman. Clinically, both our patients presented with abdominal masses without obvious signs and symptoms related to gallbladder carcinoma. Radiology suggested the possibility of a primary ovarian tumor with chronic cholecystitis and cholelithiasis. The gross features also mimicked a primary malignant ovarian tumor in the first case and a benign mucinous neoplasm in the second case. Exact diagnoses could only be made after thorough sampling from both the ovaries and gallbladder.

Conclusions: Gallbladder carcinoma with metastasis to the ovaries can mimic both malignant and benign primary ovarian tumors. Extensive cystic change in the ovary due to metastasis from gallbladder carcinoma has rarely been reported. A high index of suspicion and thorough sampling are essential to avoid misdiagnosis in such cases.