Multiple Cutaneous Nodules as Clinical Harbinger of Gallbladder Adenocarcinoma: A Case Report

Introduction: Cutaneous metastasis is defined as invasion of the skin by malignant cells originating elsewhere in the body. Cutaneous metastasis of adenocarcinoma gall bladder is extremely rare. The skin can be involved simultaneously or metachronously with the primary tumor. Here, we reported a case of cutaneous metastases as a clinical harbinger to an otherwise difficult to diagnose primary adenocarcinoma gallbladder.Case presentation: A 46-year-old male presented with multiple nodules on scalp, trunk, and limbs along with fever, weight loss, and lymphadenopathy. Histopathologic examination of the nodule revealed a malignant infiltrating glandular neoplasm in dermis, consistent with metastatic adenocarcinoma with intestinal metaplasia on immunohistochemistry. Radiological investigations further confirmed the primary tumor in gall bladder with metastases in liver and lymph nodes. Unfortunately, the patient succumbed to his disease.Discussion: Gallbladder adenocarcinoma is the most commonly seen tumor of the biliary tract. Skin involvement in malignancy helps determine the treatment course and has inevitable prognostic significance.Conclusion: We reported multiple cutaneous nodules as a remote manifestation of gallbladder adenocarcinoma. Biopsy of the skin lesion was easy to perform and quite reliably guided us toward the diagnosis of the primary tumor which would have been very difficult to diagnose otherwise.