Metastatic cervical cancer presenting as cholecystitis

Gastrointestinal metastases from squamous cell carcinomas of the cervix are rare and primarily noted on postmortem examinations. A 28-year-old woman with stage IIIa squamous cell carcinoma of the cervix presented with signs and symptoms of cholecystitis after completing primary irradiation. Operative findings revealed metastatic squamous cell cancer in the gallbladder wall with extensive lymph vascular space invasion. No other evidence of recurrent disease was found. The patient was treated with local external beam radiotherapy followed by systemic carboplatin chemotherapy and has remained disease-free for 6 months. Diagnosis of isolated recurrence in the upper gastrointestinal tract is difficult, since symptoms may mimic a number of nonneoplastic conditions. As this case illustrates, clinical suspicion in high-risk patients should be combined with an aggressive diagnostic approach. Furthermore, treatment of recurrent disease should be considered palliative and must be individualized for each clinical case.