Gallbladder Metastasis from Renal Cell Carcinoma

We experienced a rare case of gallbladder metastasis from renal cell carcinoma (RCC). Ultrasound, computed tomographic, and magnetic resonance findings showed a hypervascular polypoid mass and correlated well with histopathologic findings. The mass showed high intensity on diffusion-weighted images, and the apparent diffusion coefficient was relatively low. These imaging findings are considered characteristic and may assist preoperative diagnosis in patients with history of RCC.

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“…1,2 Its rarity and clinical similarity to benign gallbladder diseases can make correct diagnosis difficult in a clinical situation.…”

Section: Introductionmentioning

confidence: 99%

Gallbladder Metastasis from Renal Cell Carcinoma: A Case Report with Review of the Literature

Ueda

Aoki

et al. 2015

magn reson med sci

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“…Metastatic renal cell carcinoma of the gallbladder has also been described in some case reports [3–5]. The typical diagnostic sequence begins with the detection of a polypoid lesion by routine ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Contrast Enhanced Ultrasound of a Gallbladder Lesion in a Patient with a History of Renal Cell and Rectal Cancer

Reiser

Oehmen

Walter

et al. 2013

Case Reports in Gastrointestinal Medicine

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The gallbladder is an uncommon site of metastatic cancer. Although ultrasound can be regarded as a first line investigation for the detection of gallbladder lesions, differentiation between benign and malignant tumors usually requires resection. Real-time contrast enhanced ultrasound (CEUS) is a well-established technique for the classification of liver, pancreatic, and renal diseases (Weskott, 2008). The application of CEUS in the diagnosis of gallbladder tumors has rarely been described. We report the application of contrast enhanced ultrasound for the characterization of a gallbladder lesion in a 63-year-old patient with a history of renal cell and rectal cancer.

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“…Involvement of the gallbladder is rare (as few as 0.4-0.6% of cases). 6 A review from the US in 2012 by Chung et al found only 33 cases in the published literature. 5 The median time for metachronous metastases was 4 years as opposed to the 14 years in our case.…”

Section: Discussionmentioning

confidence: 99%

Renal cell carcinoma metastases to gallbladder

McWhirter

Dulk

Terlizzo

et al. 2013

Ann R Coll Surg Engl

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A 74-year old man underwent a radical cholecystectomy for presumed gallbladder cancer. The histology of the resected specimen in fact revealed the lesion to be metastatic renal cell carcinoma from his resected right nephrectomy performed 14 years previously. Case historyWe present an unusual case of renal cell carcinoma metastasising to the gallbladder 14 years after a nephrectomy for the primary tumour. A 74-year-old man presented initially to his general practitioner with symptoms consistent with biliary colic. His liver function tests were deranged at the time with a bilirubin level of 52μmol/l, an alanine aminotransferase level of 331iu/l and an alkaline phosphatase level of 152iu/l. While awaiting ultrasonography, he was admitted to his local hospital with a further attack of symptoms although this time he had developed biliary pancreatitis that was treated conservatively. Ultrasonography at the time was inconclusive and repeat imaging was arranged three weeks later. This revealed a vascular polypoid lesion measuring 22mm x 23mm x 27mm in the gallbladder (Fig 1).At this time, the patient was continuing to suffer from attacks of biliary colic, and had developed concerning symptoms of lethargy and night sweats. It was felt that this lesion was suspicious for malignancy and he was referred to the regional hepatobiliary centre for consideration of surgery. Following discussion at the specialist multidisciplinary team meeting, it was felt that it was appropriate to offer the patient a radical cholecystectomy for suspected gallbladder malignancy. He was relatively fi t despite signifi cant ischaemic heart disease requiring a quadruple coronary artery bypass graft in 1995 and subsequent coronary stenting in 2011. He had also undergone a right nephrectomy for renal cell carcinoma in 1998, which was noted on computed tomography (CT) (Fig 2).Due to the patient's previous surgery, it was felt an open approach was more appropriate than a laparoscopic one and he underwent an uncomplicated resection, making an uneventful recovery. He was fi t enough to leave hospital on the seventh postoperative day.Histological examination of the resected specimen confi rmed complete excision with a tumour that extended into the muscle but did not breach the serosa. Surprisingly, the tumour was not of biliary origin but was confi rmed to be renal clear cell carcinoma, presumed to be spread from the primary tumour resected 14 years previously (Fig 3).The lesion was confi rmed to display the classical fi ndings of a well defi ned, unencapsulated nodule consisting of nests of clear cells in rich vascular stroma. No obvious mitotic lesions were seen. Immunohistochemistry was positive for vimentin, CAM 5.2, AE1/3, MNF116 and CD10, and negative for synaptophysin, chromogranin, CD56 and S100. A singular focus of vascular invasion was seen. Interestingly, blood clots were found in the gallbladder and cystic duct lumen. It is possible that an embolus of part of these clots could be the cause of the episode of pancreatitis prior to diagno...

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Gallbladder Metastasis from Renal Cell Carcinoma

Cited by 26 publications

References 8 publications

Gallbladder Metastasis from Renal Cell Carcinoma: A Case Report with Review of the Literature

Gallbladder Metastasis from Renal Cell Carcinoma: A Case Report with Review of the Literature

Contrast Enhanced Ultrasound of a Gallbladder Lesion in a Patient with a History of Renal Cell and Rectal Cancer

Renal cell carcinoma metastases to gallbladder

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