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Osama MA, Chatterjee P, Batra G, Nehra N, Ali S, Mohta A. Isolated intracholecystic metastasis of renal cell carcinoma: A report of a rare case. J Cancer Res Ther 2024; 20:457-459. [PMID: 38554363 DOI: 10.4103/jcrt.jcrt_1626_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/15/2022] [Indexed: 01/28/2023]
Abstract
Renal cell carcinomas are known for their unforeseeable metastatic pattern. They are known to have high metastatic potential, thus commonly associated with synchronous or metachronous metastatic presentation. At the time of diagnosis, approximately one-third of patients present with metastatic disease. We present a case of synchronous metastasis of clear cell carcinoma to the gallbladder in a 54-year-old male within two months after radical nephrectomy.
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Affiliation(s)
- Md A Osama
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Priti Chatterjee
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Gunjan Batra
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Neema Nehra
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Shadan Ali
- Department of Surgery, Lady Hardinge Medical College, New Delhi, India
| | - Anup Mohta
- Department of Surgery, Lady Hardinge Medical College, New Delhi, India
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Baloğlu MC, Yahşi S, Erol Fenercioğlu Ö, Çermik TF, Ergül N. Gallbladder Metastasis From Renal Cell Carcinoma Revealed With 18 F-FDG PET/CT. Clin Nucl Med 2022; 47:e587-e588. [PMID: 35452011 DOI: 10.1097/rlu.0000000000004226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Gallbladder metastasis from renal cell carcinoma is a rare condition. To our knowledge, only 1 case has been reported with 18 F-FDG PET/CT findings. Herein, we report the case of a 53-year-old man with renal cell carcinoma, having gallbladder metastasis revealed with restaging 18 F-FDG PET/CT.
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Affiliation(s)
- Mehmet Can Baloğlu
- From the Clinic of Nuclear Medicine, University of Health Sciences, Istanbul Training and Research Hospital
| | - Seyfettin Yahşi
- Department of Pathology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Özge Erol Fenercioğlu
- From the Clinic of Nuclear Medicine, University of Health Sciences, Istanbul Training and Research Hospital
| | - Tevfik Fikret Çermik
- From the Clinic of Nuclear Medicine, University of Health Sciences, Istanbul Training and Research Hospital
| | - Nurhan Ergül
- From the Clinic of Nuclear Medicine, University of Health Sciences, Istanbul Training and Research Hospital
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Cho SH, Han YS, Han JR, Kwon HJ, Choi SH, Kim HT, Han MH, Chun JM. Synchronous gallbladder metastasis of renal cell carcinoma presenting as a gallbladder polyp: A case report. Medicine (Baltimore) 2021; 100:e24037. [PMID: 33546003 PMCID: PMC7837895 DOI: 10.1097/md.0000000000024037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 12/04/2020] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Gallbladder polyps are common in the general population, but gallbladder metastasis of renal cell carcinoma (RCC) is very rare. In a patient with RCC diagnosed with a small gallbladder polyp that does not meet the traditional size criteria, the surgeon faces a dilemma of whether cholecystectomy should be performed given the possibility of metastasis. PATIENT CONCERNS A 55-year-old man who had received a left nephrectomy for RCC presented with a gallbladder polyp that was noted at the time of the nephrectomy. Imaging showed the maximum diameter of the polyp had increased from 5 mm to 24 mm in the 40 months after the initial diagnosis. DIAGNOSIS Pathological and immunohistology findings confirmed the gallbladder polyp as a metastasis of clear-cell RCC. INTERVENTIONS : We performed a laparoscopic cholecystectomy. OUTCOMES Even though the synchronous solitary gallbladder metastasis was left untreated and a cholecystectomy was not performed over the 40 months, no metastasis occurred in other sites. The patient is free from disease 10 months after the cholecystectomy. LESSONS Solitary gallbladder metastasis of RCC may have more favorable outcomes than typical metastases. Although gallbladder metastasis of RCC occur rarely, it can occur, and any changes in gallbladder polyps in RCC patients should be managed under a strong suspicion of metastasis.
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Affiliation(s)
| | | | | | | | | | | | - Man-Hoon Han
- Department of Pathology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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The Unusual Presentation of a Single Case of Synchronous Metastatic Clear Cell Renal Cell Carcinoma to the Gallbladder: A Case Report and Literature Review. CURRENT HEALTH SCIENCES JOURNAL 2021; 47:457-461. [PMID: 35003781 PMCID: PMC8679144 DOI: 10.12865/chsj.47.03.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 09/27/2021] [Indexed: 11/18/2022]
Abstract
Clear cell renal cell carcinoma, accounts for approximately 70% of all adult renal tumors. This disease is well known for its high metastatic potential, with estimates of 25-50% of patients reporting metastasis to distant structures. However, there have only been several reported cases in medical literature describing hematogenous spread to the gallbladder, with the majority occurring metachronously, in males, and with multiple metastases. This case report follows an extremely unique presentation in a 60-year-old female. Although the patient did not exhibit the usual signs and symptoms or meet the typical demographics seen with metastatic renal cell carcinoma, it should find a place on the differential diagnosis list when a gallbladder lesion is detected on imaging during the initial staging and/or restaging in patients with renal-cell carcinoma.
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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.
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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
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White I, Smith S, Rizkalla K, Davies E. Unexpected Gallbladder Metastasis of Clear Cell Renal Carcinoma. CLINICAL PATHOLOGY 2019; 12:2632010X19861112. [PMID: 31384752 PMCID: PMC6647197 DOI: 10.1177/2632010x19861112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 06/10/2019] [Indexed: 12/19/2022]
Abstract
Renal cell carcinoma (RCC) commonly metastasizes to areas such as the lungs, liver, bone, brain, adrenals, and lymph nodes. We present a rare case of a 59-year-old female patient with RCC metastasis to the gallbladder. The patient had undergone right nephrectomy for RCC more than 6 years prior to the metastasis. During routine follow-up, a polypoid lesion of the gallbladder was identified. Laparoscopic cholecystectomy was performed, and pathologic examination of the specimen revealed metastatic RCC. The patient was completely asymptomatic, which reinforces the importance of postoperative follow-up. Renal cell carcinoma is one of the few common malignancies for which there is good evidence of survival benefit from surgical resection of the metastatic tumours.
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Affiliation(s)
- Ian White
- Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada
| | - Shane Smith
- Division of General Surgery, London Health Sciences Centre, University of Western Ontario, London, ON, Canada
| | - Kamilia Rizkalla
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, ON, Canada
| | - Edward Davies
- Division of General Surgery, London Health Sciences Centre, University of Western Ontario, London, ON, Canada
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Ueda J, Makino H, Yokoyama T, Maruyama H, Hirakata A, Takata H, Seki N, Kikuchi Y, Yoshioka M, Irie T, Yoshida H. Rare Case of Synchronous Cystic Duct Metastasis from Renal Cell Carcinoma. J NIPPON MED SCH 2019; 86:242-247. [PMID: 31061254 DOI: 10.1272/jnms.jnms.2018_86-405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The common metastatic sites of renal cell cancer (RCC) are the lung, bone, liver, brain, adrenal glands, and contralateral kidney. Metastasis to the gallbladder is rare, and cystic duct metastasis from RCC has been reported in only one metachronous case. This is the first report of a case of synchronous cystic duct metastasis from RCC. CASE REPORT A 72-year-old woman presenting with hematuria had a history of Cushing disease approximately 10 years previously. Enhanced computed tomography of the abdomen showed a mass measuring 5.8 × 3.0 cm in the left kidney, which was strongly enhanced in the early phase and washed out in the late phase. A mass measuring 2 cm in diameter was seen in the left adrenal gland, and a 1.0-cm mass was noted in the right adrenal gland. Multiple tiny masses were detected in the cystic duct. Left renal cell carcinoma, cystic duct metastasis, and bilateral adrenal gland metastases were diagnosed. Because the metastatic tumor was close to the common bile duct, we performed left nephrectomy, bilateral adrenalectomy, cholecystectomy, resection of the extrahepatic bile duct, and hepaticojejunostomy. Pathological findings showed that the renal tumor was clear cell carcinoma, as were the bilateral adrenal tumors and cystic duct tumor. The patient died 30 months after the operation.
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Affiliation(s)
- Junji Ueda
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Hiroshi Makino
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Tadashi Yokoyama
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Hiroshi Maruyama
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Atsushi Hirakata
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Hideyuki Takata
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Natsuki Seki
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | - Yuta Kikuchi
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
| | | | - Toshiyuki Irie
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital
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Alves Ribeiro M, Petersen da Costa Ferreira C, de Lucia Hernani B, Szutan LA, Galli Mortati MC, Toledo Bueno Pereira F, Kater F. Uncommon site of metastasis from renal cell carcinoma: Case report. Int J Surg Case Rep 2019; 56:45-48. [PMID: 30849687 PMCID: PMC6406048 DOI: 10.1016/j.ijscr.2019.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/29/2019] [Accepted: 02/06/2019] [Indexed: 11/19/2022] Open
Abstract
Renal carcinoma represents 1–3% of visceral malignancies. Metastases of renal tumors may manifest up to a decade after initial injury. Gallbladder represents a rare site of metastatic site, with few reports in the literature.
Background Renal cell carcinomas (CCR) account for 90% of renal tumors. Presence of latent distant metastasis is characteristic of RCC and may manifest more than a decade after nephrectomy. Gallbladder (GB) is a rare site of metastasis, with few reports in the literature. A case of metastasis from RCC to GB nine years after initial diagnosis is reported herein. Case report Male patient, 74 years, nine years post right radical nephrectomy for grade 2 clear-cell adenocarcinoma, T3BN0M0. During onset, Magnetic Resonance Imaging (MRI) evidenced T2-weighted hypointense and T1-weighted hyperintense lesion, with early and persistente contrast enhancement and exophytic bulging of the underlying outer vesicular margin. T1-weighted hypointense and T2-weighted slightly hyperintense nodular formation was also evidenced in the body portion of the pancreas, with 1.5 × 1.2 cm. The patient was subjected to videolaparoscopic cholecystectomy associated to endoscopic ultrasound (EUS) intraoperatively for investigation of the pancreatic nodule. The anatomopathological examination of the gallbladder was compatible with infiltrating metastasis from clear-cell carcinoma of primary renal site. A solid, hypoechoic, oval nodule with 14 mm was found at EUS, which cytology was suggestive of clear-cell Carcinoma. Because this is an indolent disease with oligometastasis, local ablative treatment with fractionated stereotactic radiation therapy with a dose of 40 Gy was selected. The patient is found with stable disease one year after radiation therapy. Conclusion Gallbladder is an unusual site of RCC metastasis. In patients with history of this disease, all vesicular lesions should be given attention, even where the primary tumor has been treated many years before.
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Affiliation(s)
- Mauricio Alves Ribeiro
- Department of Surgery, Irmandade da Santa Casa de Misericórdia de São Paulo and Real e Benemérita Associação Portuguesa de Beneficência, Brazil
| | - Caroline Petersen da Costa Ferreira
- Department of Surgery, Irmandade da Santa Casa de Misericórdia de São Paulo and Real e Benemérita Associação Portuguesa de Beneficência, Brazil.
| | - Bruno de Lucia Hernani
- Department of Surgery, Irmandade da Santa Casa de Misericórdia de São Paulo and Real e Benemérita Associação Portuguesa de Beneficência, Brazil
| | - Luiz Arnaldo Szutan
- Department of Surgery, Irmandade da Santa Casa de Misericórdia de São Paulo and Real e Benemérita Associação Portuguesa de Beneficência, Brazil
| | | | - Fabiana Toledo Bueno Pereira
- Department of Pathology, Irmandade da Santa Casa de Misericórdia de São Paulo and Real e Benemérita Associação Portuguesa de Beneficência, Brazil
| | - Fabio Kater
- Department of Oncology, Real e Benemérita Associação Portuguesa de Beneficência, Brazil
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Takagi K, Kawase K, Minoshima K, Yamaha M, Maekawa Y, Yokoi S, Kusakabe M, Horie M. Gallbladder metastasis from renal cell carcinoma: A case report and literature review. Urol Case Rep 2019; 23:69-71. [PMID: 30705826 PMCID: PMC6348693 DOI: 10.1016/j.eucr.2019.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/08/2019] [Indexed: 12/15/2022] Open
Affiliation(s)
- Kimiaki Takagi
- Department of Urology, Daiyukai Daiichi Hospital, 1-6-12 Hagoromo, Ichinomiya City, Aichi, 491-0025, Japan
| | - Kota Kawase
- Department of Urology, Daiyukai Daiichi Hospital, 1-6-12 Hagoromo, Ichinomiya City, Aichi, 491-0025, Japan
| | - Kenichi Minoshima
- Department of Urology, Daiyukai Daiichi Hospital, 1-6-12 Hagoromo, Ichinomiya City, Aichi, 491-0025, Japan
| | - Masayoshi Yamaha
- Department of Urology, Daiyukai Daiichi Hospital, 1-6-12 Hagoromo, Ichinomiya City, Aichi, 491-0025, Japan
| | - Yuka Maekawa
- Department of Urology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, Gifu, 501-1194, Japan
| | - Shigeaki Yokoi
- Department of Urology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, Gifu, 501-1194, Japan
| | - Mitsuhiko Kusakabe
- Department of Surgery, Daiyukai General Hospital, 1-9-9 Sakura, Ichinomiya City, Aichi, 491-8551, Japan
| | - Masanobu Horie
- Department of Urology, Daiyukai Daiichi Hospital, 1-6-12 Hagoromo, Ichinomiya City, Aichi, 491-0025, Japan
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