1
|
Shrateh ON, Abugharbieh Y, Hour H, Abusharkh H, Bannoura S. Metastasis of incidentally diagnosed renal cell carcinoma to the sacrum 7 years after partial nephrectomy: Case report and literature review. Int J Surg Case Rep 2023; 111:108867. [PMID: 37769410 PMCID: PMC10539926 DOI: 10.1016/j.ijscr.2023.108867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION After undergoing partial nephrectomy for renal cell carcinoma (RCC), approximately 20-40 % of patients may develop either distant metastatic disease or locally recurring disease. Delayed occurrence of metastasis is an important aspect to consider in the management and monitoring of patients with renal cell carcinoma. CASE PRESENTATION A 69-years-old male who had been followed up for liver hemangioma, an incidental enhancing right renal mass was discovered which then revealed to be renal cell carcinoma on computed tomography scan. The patient underwent a partial nephrectomy in 2016without any reported complications, complaints, adverse event and/or re-admissions. Seven years following the surgery, the patient began experiencing left hip pain, leading him to seek medical advice which is then confirmed to be a cancerous metastasis of the renal origin. CLINICAL DISCUSSION Advocating for extended surveillance protocols is important to ensure that patients receive optimal care and that any disease progression is identified promptly. Early detection and intervention may lead to better treatment outcomes and improved patient survival. Therefore, continued vigilance and close monitoring of patients with RCC, even after long periods of disease-free survival, are essential components of comprehensive cancer care. CONCLUSION This case highlights the challenges in predicting and detecting the occurrence of metastases in renal cell carcinoma despite regular surveillance and follow-up examinations. The delayed appearance of the metastatic lesion underscores the importance of continued vigilance and thorough monitoring even in cases where initial imaging and blood tests appear unremarkable in patients with renal cell carcinoma.
Collapse
Affiliation(s)
- Oadi N Shrateh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
| | | | - Hani Hour
- Department of Oncology, Al-Ahli Hospital, Hebron, Palestine
| | - Hussein Abusharkh
- Department of Interventional Radiology, Al-Ahli Hospital, Hebron, Palestine
| | - Sami Bannoura
- Department of Pathology, Al-Ahli Hospital, Hebron, Palestine
| |
Collapse
|
2
|
Muacevic A, Adler JR, Sultan A, Khalid W, Siddique K. A Rare Case of Single Gallbladder and Multiple Pancreatic Metastases of Renal Cell Carcinoma. Cureus 2022; 14:e31861. [PMID: 36579299 PMCID: PMC9789789 DOI: 10.7759/cureus.31861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 11/25/2022] Open
Abstract
Renal cell carcinoma (RCC) is the most common tumor to metastasize to uncommon sites. Synchronous metastases in the gall bladder and pancreas are rare entities. In this report, we present the case of a 43-year-old male with a complaint of hematuria presenting with a left renal mass. Contrast-enhanced CT revealed an arterially enhancing mass in the left kidney, a synchronous tiny polyp in the gall bladder, and multiple focal lesions in the pancreas. The patient underwent surgery and the tumor was histopathologically labeled as a clear cell RCC with metastases to the pancreas and gall bladder. Post-surgery, the patient has been followed up.
Collapse
|
3
|
Dergamoun H, Gdaouni AE, Ziouziou I. Renal cell carcinoma with gallbladder metastasis: a case report. Pan Afr Med J 2022; 43:106. [PMID: 36699978 PMCID: PMC9834804 DOI: 10.11604/pamj.2022.43.106.36588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/06/2022] [Indexed: 01/27/2023] Open
Abstract
Renal cell carcinoma (RCC) is the most frequent renal neoplasm, with a high rate of metastasis, especially in the lungs and bones. The gallbladder is one of the rare metastatic sites. We report an 80-year-old woman who presented with chronic right flank pain for the last six months. A computer tomography scan revealed a heterogeneous right renal mass measuring 86 ×76× 68 mm and multi lithiasis in the gallbladder. A right radical nephrectomy, lymphadenectomy, and cholecystectomy were performed. The postoperative clinical course was uneventful, without any complications. The histological results showed a clear RCC with metastasis to the gallbladder. After 12-months follow-up, the patient is free from disease. In conclusion, even though the coexistence of metastatic gallbladder from clear RCC is rare, the possibility of concurrence should be considered if suspected findings in the gallbladder are identified intraoperatively.
Collapse
Affiliation(s)
- Hamza Dergamoun
- Department of Anatomy, Agadir University Hospital, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco,,Department of Urology, Agadir University Hospital, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Abdelaziz El Gdaouni
- Department of Urology, Agadir University Hospital, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco,Corresponding author: Abdelaziz El Gdaouni, Department of Urology, Agadir University Hospital, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco.
| | - Imad Ziouziou
- Department of Urology, Agadir University Hospital, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| |
Collapse
|
4
|
Cocco G, Delli Pizzi A, Basilico R, Fabiani S, Taraschi AL, Pascucci L, Boccatonda A, Catalano O, Schiavone C. Imaging of gallbladder metastasis. Insights Imaging 2021; 12:100. [PMID: 34259932 PMCID: PMC8280258 DOI: 10.1186/s13244-021-01049-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/13/2021] [Indexed: 12/29/2022] Open
Abstract
Gallbladder metastasis (GM) is a rare condition, often with a late diagnosis or detected upon autopsy. There is no extensive literature on the imaging diagnosis of GM. Here we present a comprehensive review of the literature with the aim of helping to interpret the clinical findings and imaging features of such patients. Few studies on GM are reported in literature. GM by melanoma accounts for about 55.6% of cases. The remaining cases origin from breast cancer (13.6%), hepatocellular carcinoma (13.6%), renal cell carcinoma (6.8%), lung cancer (4.5%), lymphoma (3.5%) and gastric cancer (2.4%). The most common clinical presentation of GM is abdominal pain from cholecystitis due to obstruction of the cystic duct. The main ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) findings that clinicians and radiologists should consider in their everyday medical activity were discussed. The diagnosis of GM was often achieved through a combination of more than one imaging modality. In more than 90% of cases, the diagnosis of GM is often late and combined with other organs involvement in the terminal stage of the malignancy. The knowledge of the clinical features and different imaging techniques through careful evaluation of the gallbladder can help to achieve early diagnosis and avoid misdiagnosis or false negative results.
Collapse
Affiliation(s)
- Giulio Cocco
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, "G.D'Annunzio" University, Chiety, Italy.
| | - Andrea Delli Pizzi
- Department of Neurosciences, Imaging and Clinical Studies, "G.D'Annunzio" University, Chiety, Italy
| | - Raffaella Basilico
- Department of Neurosciences, Imaging and Clinical Studies, "G.D'Annunzio" University, Chiety, Italy
| | - Stefano Fabiani
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, "G.D'Annunzio" University, Chiety, Italy
| | - Alessio Lino Taraschi
- Department of Neurosciences, Imaging and Clinical Studies, "G.D'Annunzio" University, Chiety, Italy
| | - Luca Pascucci
- Department of Neurosciences, Imaging and Clinical Studies, "G.D'Annunzio" University, Chiety, Italy
| | - Andrea Boccatonda
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, "G.D'Annunzio" University, Chiety, Italy
| | | | - Cosima Schiavone
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, "G.D'Annunzio" University, Chiety, Italy
| |
Collapse
|
5
|
Kim CG, Kim SH, Cho SH, Ryeom HK. Gallbladder Metastasis of Renal Cell Carcinoma: A Case Report. TAEHAN YONGSANG UIHAKHOE CHI 2021; 82:959-963. [PMID: 36238078 PMCID: PMC9514411 DOI: 10.3348/jksr.2020.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/24/2020] [Accepted: 08/11/2020] [Indexed: 11/15/2022]
Abstract
The gallbladder (GB) is a rare site of renal cell carcinoma (RCC) metastasis. To the best of our knowledge, only a few reports of CT findings of GB metastasis exist in the literature. Herein, we report a case of histologically proven GB metastasis of RCC in a 55-year-old male who underwent CT for an intraluminal polypoid mass simulating a primary GB lesion.
Collapse
|
6
|
Oba T, Sato N, Tamura T, Fujimoto K, Matsuyama A, Hirata K. Gallbladder metastasis of renal cell carcinoma presenting as a hypervascular polypoid lesion: case report of two cases with immunohistochemical analysis. Surg Case Rep 2020; 6:86. [PMID: 32347406 PMCID: PMC7188748 DOI: 10.1186/s40792-020-00814-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 03/05/2020] [Indexed: 12/17/2022] Open
Abstract
Background Metastasis of renal cell carcinoma (RCC) to the gallbladder is rare, and its clinicopathological feature remains poorly understood. We here present two cases of gallbladder metastasis from RCC presenting as a hypervascular polypoid lesion. Case presentation The first case was a 73-year-old man who had undergone right nephrectomy for clear cell RCC. Imaging studies detected a hypervascular polypoid lesion in the gallbladder 6 years after nephrectomy. Laparoscopic cholecystectomy was done. The pathological findings of the polypoid lesion showed proliferation of clear cells in the submucosal layer. Immunohistochemically, the tumor was positive for carbonic anhydrase 9 (CA9) but negative for cytokeratin 7 (CK7), suggestive of metastatic RCC. The second case was a 43-year-old man who had undergone right nephrectomy for clear cell RCC. Imaging studies revealed a hypervascular polypoid lesion of 20 mm in diameter in the gallbladder 1 year after nephrectomy. The patient underwent expanded cholecystectomy and extra-hepatic bile duct resection with lymphadenectomy. Microscopically, the polypoid lesion of the gallbladder was composed of clear cells in the submucosal layer. Immunohistochemical analysis showed positive staining for epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA) but negative staining for CK7, leading to the diagnosis of metastatic RCC. Conclusions Gallbladder metastasis from RCC is rare but should be considered when a hypervascular polypoid lesion in the gallbladder is detected during the follow-up period after RCC treatment.
Collapse
Affiliation(s)
- Takuya Oba
- Department of Surgery1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan.
| | - Norihiro Sato
- Department of Surgery1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Toshihisa Tamura
- Department of Surgery1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Katsushi Fujimoto
- Department of Surgery1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Atsuji Matsuyama
- Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Keiji Hirata
- Department of Surgery1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| |
Collapse
|
7
|
Zouari S, Ben Othmen M, Abdessayed N, Larbi Mama N, Jarrar MS, Sriha B, Mokni M, Jaidane M, Hmida W. Metastatic renal clear cell carcinoma mimicking a gallbladder polyp: Case report and literature review. Int J Surg Case Rep 2019; 64:133-138. [PMID: 31655282 PMCID: PMC6818339 DOI: 10.1016/j.ijscr.2019.09.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/12/2019] [Accepted: 09/18/2019] [Indexed: 12/27/2022] Open
Abstract
Metastases to gallbladder from renal cell carcinoma are very rare. Most of the cases are diagnosed incidentally, and both clinical presentation and physical examination are unspecific. Imaging although its specificity can’t make the difference between primary gallbladder carcinoma and metastasis from RCC. Only pathological examination of the specimen after cholecytectomy with immunochemistery can assess the diagnosis.
Introduction Metastatic tumors to the gallbladder are uncommon. Metastases from renal cell carcinoma (RCC) to the gallbladder are exceptional. Frequencies of less than 0.6% reported in large autopsy reviews and few cases have been reported in the literature. Presentation of case Herein we present a case of a 50-year-old man that developed four years after radical nephrectomy for RCC, a gallbladder metastasis, discovered incidentally on Computed Tomography (CT) scan. It was described as an intraluminal gallbladder polyp. Radiological features were very suggestive of primary gallbladder carcinoma, thus the patient had a laparoscopic cholecystectomy. The pathological examination of the surgical specimen concluded to a RCC metastasis. Immunochemistry with vimentin and pancytokeratin were supportive of this diagnosis. The clinical course was uneventful after 18 months period of follow up. Discussion At the time of presentation, almost one-third of the patients with RCC are metastatic. Metastases to the gallbladder are extremely rare. Clinical presentation and physical examination are unspecific. Radiological findings can raise information and orient the diagnosis although the difference between both diagnoses remains difficult. Usually, it is a pedunculated and not associated with gallstones with enhancement on CT scan. The treatment remains surgical with R0 cholecystectomy, and prognosis is mainly related to disease free interval and single site metastasis. Conclusion We highlight here the challenge to make the difference between a primary gallbladder carcinoma and metastasis from RCC. Diagnosis is made on pathological examination and immunochemistry.
Collapse
Affiliation(s)
- Skander Zouari
- Sahloul Hospital, Department of Urology, Route de la ceinture, Hammam Sousse, 4011, Sousse, Tunisia
| | - Mouna Ben Othmen
- Sahloul Hospital, Department of Urology, Route de la ceinture, Hammam Sousse, 4011, Sousse, Tunisia
| | - Nihed Abdessayed
- Farhat Hached Hospital, Department of Histopathology, Ibn El Jazzar Road, Sousse Ezzouhour, 4031, Sousse, Tunisia; Research Lab: Transfer in Technology in Anatomic Pathology (LR12SP08), Tunisia.
| | - Nadia Larbi Mama
- Sahloul Hospital, Department of Radiology, Route de la ceinture, Hammam Sousse, 4011, Sousse, Tunisia
| | - Mohamed Salah Jarrar
- Farhat Hached Hospital, Department of General Surgery, Ibn El Jazzar Road, Sousse Ezzouhour, 4031, Sousse, Tunisia
| | - Badreddine Sriha
- Farhat Hached Hospital, Department of Histopathology, Ibn El Jazzar Road, Sousse Ezzouhour, 4031, Sousse, Tunisia; Research Lab: Transfer in Technology in Anatomic Pathology (LR12SP08), Tunisia
| | - Moncef Mokni
- Farhat Hached Hospital, Department of Histopathology, Ibn El Jazzar Road, Sousse Ezzouhour, 4031, Sousse, Tunisia; Research Lab: Transfer in Technology in Anatomic Pathology (LR12SP08), Tunisia
| | - Mehdi Jaidane
- Sahloul Hospital, Department of Urology, Route de la ceinture, Hammam Sousse, 4011, Sousse, Tunisia
| | - Wissem Hmida
- Sahloul Hospital, Department of Urology, Route de la ceinture, Hammam Sousse, 4011, Sousse, Tunisia
| |
Collapse
|