Puglisi Francesco, Capuano Palma, Gentile Antonia, Lobascio Pierluigi, Russo Silvana, Martines Gennaro, Lograno Giuseppe, Memeo Vincenzo
Unit of General Surgery and Liver Transplantation, University of Bari, Italy.
Tumori. 2005 Sep-Oct;91(5):428-31. doi: 10.1177/030089160509100510.
Extra-abdominal metastases from gallbladder cancer are very rare; the sites outside the abdomen most frequently affected are the skin, bone and central nervous system. In the literature, only one case of orbital metastasis from gallbladder cancer has been reported, in a patient previously treated by open cholecystectomy. We report the case of a 53-year-old woman who underwent a laparoscopic cholecystectomy for symptomatic gallbladder stones. Postoperative histological examination revealed an unsuspected gallbladder adenocarcinoma. One month later she came to our observation after having developed diplopia and ophthalmic pain due to an orbital metastasis. We decided not to perform a surgical second look because of the already rapid dissemination of the malignant tumor. The few cases of uncommon gallbladder cancer metastases after laparoscopic cholecystectomy described in the literature are discussed, as well as the possible role of laparoscopy in the dissemination and localized seeding of malignant cells.
胆囊癌的腹外转移非常罕见；腹部以外最常受累的部位是皮肤、骨骼和中枢神经系统。在文献中，仅报道过1例胆囊癌眼眶转移病例，该患者此前接受过开腹胆囊切除术。我们报告1例53岁女性，因有症状的胆囊结石接受了腹腔镜胆囊切除术。术后组织学检查发现了意外的胆囊腺癌。1个月后，她因眼眶转移出现复视和眼痛后来我院就诊。由于恶性肿瘤已迅速扩散，我们决定不进行二次手术探查。文中讨论了文献中描述的腹腔镜胆囊切除术后罕见的胆囊癌转移的少数病例，以及腹腔镜检查在恶性细胞播散和局部种植中的可能作用。
