Gallbladder Metastasis of Renal Cell Carcinoma: Report of Two Cases

Abstract

We report two extremely rare cases of metastasis to the gallbladder from renal cell carcinoma. In both men, aged 63 and 80 years, a pedunculated polypoid gallbladder tumor was incidentally found 27 and 8 years after surgery for renal cell carcinoma, respectively. The tumors showed hypervascularity on diagnostic imaging. A histopathological examination showed no tumor cells in the gallbladder mucosa. but clear cell carcinoma was predominantly observed below the mucosal layer. Furthermore, based on various specific and immunohistochemical studies as well as the electronmicroscopic findings, the patients were pathologically diagnosed to have gallbladder metastasis of renal cell carcinoma.

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

“…In this case metastastic gallbladder carcinoma may resemble primary carcinoma of the gallbladder. Metastatsis may be limited to the muscle layer and perimuscular connective tissue and doesn't necessarily involve the mucosa [6,8,18,21]. In immunohistochemistry, primary carcinoma of the gallbladder is positive for CK7 and CEA, while metastatic RCC is negative for these antigens [22].…”

Gallbladder Metastasis of Non-Small Cell Lung Cancer

“…The tumor most likely to metastasize into the gallbladder is malignant melanoma with more than 20 cases of symptomatic gallbladder metastases reported in literature [5,7]. Other tumors shown to cause clinically significant metastases to the gallbladder include renal cell carcinoma [3,8], infiltrating lobular [9] and ductal [9,10] adenocarcinoma of the breast, squamous cell carcinoma of the cervix [4] and hepatocellular carcinoma [11]. Most secondary tumors of the gallbladder do not cause clinical symptoms.…”

“…Our patient developed symptoms related to his gallballder metastasis 13 months after diagnosis of NSCLC. Most gallbladder metastases are detected metachronously; in one case reported by Aoki et al [3] a gallbladder metastasis appeared 27 years after nephrectomy for renal cell carcinoma. Ultrasound patterns of metastatic tumors in the gallbladder are well described [13,14].…”

“…Metastases of the gallbladder wall are mostly incidental postmortal findings [2]. Only few cases of different types of cancer are reported in whom gallbladder metastases caused clinical symptoms [3][4][5].…”

Asymptomatic Metachronous Solitary Metastasis to the Gallbladder from Renal Cell Carcinoma: Report of a Case

“…Widespread hematogenous dissemination in the terminal stages of RCC is common, but cases of solitary intracholecystic metastasis diagnosed ante mortem are extremely rare [1-3], and the incidence in two large autopsy series was 0.57% (3 of 523 autopsies) [2] and 0.58% (4 of 687 autopsies) [3]. To date, only 8 cases, including this one, of solitary metastatic disease within gallbladder have been reported [10][11][12][13][14][15][16]. Metastases to the gallbladder often begin as a submucosal nodule that eventually become pedunculated and may resemble primary carcinoma of the gallbladder [4].…”