A galling connection- an unusual lesion on the abdomen of a 101-year-old lady

A 101-year-old lady was referred via the urgent cancer referral pathway with a lesion on the right upper quadrant of her abdomen. She reported regular discharge of a green fluid from it but the lesion was otherwise painless. CT scan confirmed a cholecystocutaneous fistula connecting the gallbladder and the skin, likely a consequence of an episode of cholecystitis treated 6 months prior to our review. We all know that lesions referred as suspected skin cancers are usually benign, pre-cancerous or cancerous, but as it turns out, some may be fistulous!