Real-time contrast enhanced ultrasound-guided percutaneous biopsy in diagnosing gallbladder carcinoma metastasising to the ovaries:a case report

Abstract

Abstract Introduction：Multiple-organ primary tumors can invade the ovary through lymphatic and hematogenous routes presenting as ovarian Krukenberg tumors (KT);however they rarely originate from the gallbladder and are often present as primary ovarian tumors;however,their treatments are totally different. Patient concerns:A 62-year-old Chinese woman presented with abdominal distension for Six months and a weight loss of 5 kg for two months. Diagnoses: Base on multiple imaging examinations,the patient was preliminarily diagnosed with a malignant tumor of unknown origin with multiple metastases(liver,gallbladder,right-adnexal,omentum).To identify the origin of the malignancy,the patient received real-time contrast enhanced ultrasound-guided (CEUS-guided) percutaneous biopsy.The postsurgical pathologic examination showed perihepatic hypoecho and right-adnexal mass were both metastatic adenocarcinoma from the gallbladder. Interventions: The patient received chemotherapy with gemcitabine and cisplatin instead of surgery,however,after six cycles, the lesion increased after reexamination, so the treatment was changed to combination with duvariumab regimen for 5 cycles. Outcomes:At present, the treatment process went smoothly with no recurrence or obvious progress during follow-up. Conclusions: Differential diagnosis between primary and metastatic ovarian tumors is important.Early diagnosis and effective treatment options are essential for patient survival.The punch biopsy is significant for patients with multiple metastases that cannot tolerate surgery. Ethical compliance: All procedures performed in studies involving human participants comply with the ethical standards of the institutional and / or national research committees and with the 1964 Helsinki Declaration and its later amendments or similar ethical standards. Data Access Statement: The research data supporting this publication is available from the NN repository at www.NNN.org/download/