1
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Han X, Shu Q, Shi S, Liu H, Han S, Zhang Z. Ependymoma with metastases to the gallbladder: A case report and literature review. Oncol Lett 2024; 27:72. [PMID: 38192669 PMCID: PMC10773199 DOI: 10.3892/ol.2023.14205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/07/2023] [Indexed: 01/10/2024] Open
Abstract
Metastatic ependymoma of the gallbladder is an exceptionally rare condition that remains relatively unreported in the scientific literature. The present study described a case involving a 42-year-old female patient who underwent right frontal lobe surgery for ependymoma in 2017 and subsequently received adjuvant chemotherapy. The histological examination of the surgical specimen confirmed the presence of ependymoma metastasis in the gallbladder. The presentation and outcome of this patient with regard to metastatic ependymoma in the gallbladder were evaluated. During a follow-up period of 10 months, the patient received targeted treatment following the surgery. Presently, the patient has developed lung and bone metastases. In the present report, the treatment and diagnostic approach utilized in this unique case were outlined with the aim of providing valuable insight for future clinical management and enhancing clinicians' understanding of the disease.
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Affiliation(s)
- Xinying Han
- Department of Pathology, Cangzhou People's Hospital, Cangzhou, Hebei 061001, P.R. China
| | - Qingming Shu
- Department of Pathology, The Third Medical Center of The Chinese People's Liberation Army General Hospital, Beijing 100039, P.R. China
| | - Shuai Shi
- Department of Pathology, Cangzhou People's Hospital, Cangzhou, Hebei 061001, P.R. China
| | - Hongzheng Liu
- Department of Orthopedics, The Hospital of Integrated Traditional and Western Medicine of Cangzhou, Cangzhou, Hebei 061001, P.R. China
| | - Songlin Han
- Department of Pathology, Cangzhou People's Hospital, Cangzhou, Hebei 061001, P.R. China
| | - Zhigang Zhang
- Department of Pathology, Cangzhou People's Hospital, Cangzhou, Hebei 061001, P.R. China
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2
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Syposs C, Agostini-Vulaj D. Metastatic large-cell neuroendocrine carcinoma of the lung masquerading as a primary gallbladder carcinoma: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231166773. [PMID: 37063435 PMCID: PMC10102936 DOI: 10.1177/2050313x231166773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 03/13/2023] [Indexed: 04/18/2023] Open
Abstract
Gallbladder neuroendocrine carcinoma is rare, representing ~4% of all primary malignant gallbladder neoplasms. We report the case of a 75-year-old female who presented for radiologic restaging for lung adenocarcinoma diagnosed elsewhere, demonstrating a hypermetabolic gallbladder mass. With concern for a gallbladder primary, radical cholecystectomy followed. Gross showed a 2-cm polypoid fundic mass; microscopically, tumor cells were arranged in sheets, with organoid features and necrosis, variable cytoplasm, vesicular-granular chromatin, prominent nucleoli, frequent mitoses, and apoptotic figures. Immunohistochemically, synaptophysin, chromogranin, CK7, and TTF-1 were positive; Ki67 was 80%. The combined findings were diagnostic of large-cell neuroendocrine carcinoma. Further investigation including outside slide review with additional stains revealed the lung primary to be classified large-cell neuroendocrine carcinoma, thus the gallbladder tumor representing metastasis. Within 4 months, the patient expired with widespread metastases. To our knowledge, this is the first reported case of metastatic lung large-cell neuroendocrine carcinoma to gallbladder in the English literature.
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Affiliation(s)
| | - Diana Agostini-Vulaj
- Diana Agostini-Vulaj, Department of
Pathology and Laboratory Medicine, University of Rochester Medical Center, 601
Elmwood Avenue, Box 626, Rochester, NY 14642, USA.
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3
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Kawamoto A, Kimura K, Hirose K, Izumi T, Taniguchi D, Yano H, Kajiwara Y, Minagawa R, Minami K, Oshiro Y, Nishizaki T. Synchronous gallbladder metastasis originating from residual gastric cancer: a case report and the review of literature. Surg Case Rep 2022; 8:88. [PMID: 35524891 PMCID: PMC9079201 DOI: 10.1186/s40792-022-01442-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background Gastric cancer rarely metastasizes to the gallbladder. Furthermore, there has never been a case report of simultaneous gallbladder metastasis from residual gastric cancer. Here, we report a case of synchronous gallbladder metastasis originating from a residual gastric cancer. Case presentation A 67-year-old man underwent a follow-up upper endoscopy 18 months after a partial gastrectomy for gastric cancer; an ulcerative lesion was found in the remnant stomach at the gastrojejunal anastomosis. A biopsy revealed gastric signet-ring cell carcinoma (SRCC). A full-body examination revealed no abnormalities other than gallstones in the gallbladder. With a diagnosis of residual gastric cancer (cT2N0M0 cStage I), the patient underwent open total gastrectomy and cholecystectomy. Macroscopic findings of the resected specimen revealed thickening of the gallbladder wall; however, no obvious neoplastic lesions were found on the mucosal surface of the gallbladder. The pathological findings showed that the SRCC had invaded the submucosa of the gastrojejunostomy site with a high degree of lymphatic invasion and lymph node metastases. SRCCs were also found in the lymphatic vessels of the gallbladder wall. These findings suggested the possibility of gallbladder metastasis through lymphatic vessels. The patient and his family members refused postoperative chemotherapy. Ten months after the operation, the patient experienced respiratory failure due to lymphangitis carcinomatosa and died. Conclusions At present, it is difficult to determine whether resection of the gallbladder contributes to an improved prognosis of gastric cancer patients. However, reports in such cases demonstrate that gallbladder metastasis could be a poor predictor of prognosis for gastric cancer.
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Affiliation(s)
- Ami Kawamoto
- Department of Surgery, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan
| | - Koichi Kimura
- Department of Surgery, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan.
| | - Kosuke Hirose
- Department of Surgery, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan
| | - Takuma Izumi
- Department of Surgery, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan
| | - Daisuke Taniguchi
- Department of Surgery, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan
| | - Hiroko Yano
- Department of Surgery, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan
| | - Yuichiro Kajiwara
- Department of Surgery, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan
| | - Ryosuke Minagawa
- Department of Surgery, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan
| | - Kazuhito Minami
- Department of Surgery, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan
| | - Yumi Oshiro
- Department of Pathology, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan
| | - Takashi Nishizaki
- Department of Surgery, Matsuyama Red Cross Hospital, 1, Bunkyo-cho, Matsuyama, Ehime, 790-8524, Japan
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4
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Vivas López A, Narvaez Chavez C, Marcacuzco Quinto A, Teijo Quintáns A, Justo Alonso I. Gallbladder metastasis from squamous cell carcinoma of the head and neck: Atypical presentation of airway metastasis. Cir Esp 2021; 99:688-690. [PMID: 34654660 DOI: 10.1016/j.cireng.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/25/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Alfredo Vivas López
- Servicio de Cirugía General y del Aparato Digestivo, Hospital 12 de Octubre, Madrid, Spain.
| | | | | | | | - Iago Justo Alonso
- Servicio de Cirugía General y del Aparato Digestivo, Hospital 12 de Octubre, Madrid, Spain
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5
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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.
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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
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6
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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.
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7
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Ichikawa S, Oishi N, Kondo T, Onishi H. Key Imaging Findings for the Prospective Diagnosis of Rare Diseases of the Gallbladder and Cystic Duct. Korean J Radiol 2021; 22:1462-1474. [PMID: 34132078 PMCID: PMC8390821 DOI: 10.3348/kjr.2020.1479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/09/2021] [Accepted: 03/17/2021] [Indexed: 11/15/2022] Open
Abstract
There are various diseases of the gallbladder and cystic duct, and imaging diagnosis is challenging for the rare among them. However, some rare diseases show characteristic imaging findings or patient history; therefore, familiarity with the imaging presentation of rare diseases may improve diagnostic accuracy and patient management. The purpose of this article is to describe the imaging findings of rare diseases of the gallbladder and cystic duct and identify their pathological correlations with these diseases.
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Affiliation(s)
| | - Naoki Oishi
- Department of Pathology, University of Yamanashi, Chuo, Japan
| | - Tetsuo Kondo
- Department of Pathology, University of Yamanashi, Chuo, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Chuo, Japan
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8
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Salita A, Rosado M, Mack K, Pui J, Zekman R, Dinnan K. Metastatic lobular carcinoma of the breast found incidentally on pathology following cholecystectomy for chronic cholecystitis: A case report. Int J Surg Case Rep 2021; 80:105612. [PMID: 33636408 PMCID: PMC7918255 DOI: 10.1016/j.ijscr.2021.01.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/30/2021] [Accepted: 01/31/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Traditional oncologic pattern of spread of breast cancer is metastasis to axillary lymph nodes, lung, liver and bone (Doval et al., 2006 [1]). Here we present a case of unknown synchronous breast cancer in a patient that was revealed on histopathologic assessment following elective cholecystectomy. CASE SUMMARY A 57 year old female presented for an elective laparoscopic cholecystectomy secondary to biliary colic. Histopathologic assessment of the gallbladder revealed metastatic adenocarcinoma with signet ring features, consistent with metastatic lobular carcinoma. The patient went on to have a complete oncologic workup that revealed invasive ductal carcinoma with components of high grade ductal carcinoma in situ in the left breast, lobular carcinoma in the right breast, and metastatic lobular carcinoma to left and right axillary lymph nodes as well as diffuse osseous metastatic disease. CONCLUSIONS Metastatic disease to the gallbladder found incidentally on elective cholecystectomy is a rare presentation of synchronous breast cancer.
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Affiliation(s)
- Alona Salita
- Beaumont, 28050 Grand River Avenue, Farmington Hills, MI, 48336, United States.
| | - Marcos Rosado
- Beaumont, 28050 Grand River Avenue, Farmington Hills, MI, 48336, United States.
| | - Kita Mack
- Beaumont, 28050 Grand River Avenue, Farmington Hills, MI, 48336, United States.
| | - John Pui
- Beaumont, 28050 Grand River Avenue, Farmington Hills, MI, 48336, United States.
| | - Richard Zekman
- Beaumont, 28050 Grand River Avenue, Farmington Hills, MI, 48336, United States.
| | - Kelly Dinnan
- Beaumont, 28050 Grand River Avenue, Farmington Hills, MI, 48336, United States.
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9
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Gallbladder polyps ultrasound: what the sonographer needs to know. J Ultrasound 2021; 24:131-142. [PMID: 33548050 PMCID: PMC8137797 DOI: 10.1007/s40477-021-00563-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/15/2021] [Indexed: 12/12/2022] Open
Abstract
Gallbladder polyps are protuberances of the gallbladder wall projecting into the lumen. They are usually incidentally found during abdominal sonography or diagnosed on histopathology of a surgery specimen, with an estimated prevalence of up to 9.5% of patients. Gallbladder polyps are not mobile and do not demonstrate posterior acoustic shadowing; they may be sessile or pedunculated. Gallbladder polyps may be divided into pseudopolyps and true polyps. Pseudopolyps are benign and include cholesterolosis, cholesterinic polyps, inflammatory polyps, and localised adenomyomatosis. True gallbladder polyps can be benign or malignant. Benign polyps are most commonly adenomas, while malignant polyps are adenocarcinomas and metastases. There are also rare types of benign and malignant true gallbladder polyps, including mesenchymal tumours and lymphomas. Ultrasound is the first-choice imaging method for the diagnosis of gallbladder polyps, representing an indispensable tool for ensuring appropriate management. It enables limitation of secondary level investigations and avoidance of unnecessary cholecystectomies.
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10
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Acute cholecystitis caused by gallbladder metastasis from non-small cell lung cancer: a case report. Clin J Gastroenterol 2021; 14:351-357. [PMID: 33495974 DOI: 10.1007/s12328-020-01293-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/30/2020] [Indexed: 12/07/2022]
Abstract
Although non-small cell lung cancer can metastasize to any part of the body, metastasis to the gallbladder is extremely rare. We present a case of acute cholecystitis caused by gallbladder metastasis from non-small cell lung cancer. A 66-year-old man diagnosed with primary stage IV T4N3M1b non-small cell lung cancer was admitted to our hospital to receive chemotherapy, during which he presented with right upper abdominal pain. Abdominal contrast-enhanced computed tomography showed an enhanced mass at the neck of the gallbladder and gallbladder distension with obvious wall thickening. Acute cholecystitis caused by obstruction of the gallbladder neck by malignancy was suspected. Open cholecystectomy, extrahepatic bile duct resection, and Roux-en-Y choledochojejunostomy were performed. Pathological and immunohistochemical examinations revealed gallbladder metastasis originating from non-small cell lung cancer. In conclusion, when a patient with lung cancer presents with acute cholecystitis, the rare possibility of gallbladder metastasis should be considered.
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11
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Vivas López A, Narvaez Chavez C, Marcacuzco Quinto A, Teijo Quintáns A, Justo Alonso I. Gallbladder metastasis from squamous cell carcinoma of the head and neck: Atypical presentation of airway metastasis. Cir Esp 2020; 99:S0009-739X(20)30280-3. [PMID: 33032796 DOI: 10.1016/j.ciresp.2020.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/06/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Alfredo Vivas López
- Servicio de Cirugía General y del Aparato Digestivo, Hospital 12 de Octubre, Madrid, España.
| | | | | | | | - Iago Justo Alonso
- Servicio de Cirugía General y del Aparato Digestivo, Hospital 12 de Octubre, Madrid, España
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12
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Missori G, Serra F, Prestigiacomo G, Ricciardolo AA, Brugioni L, Gelmini R. Case Report: Metastatic breast cancer to the gallbladder. F1000Res 2020; 9:343. [PMID: 33204409 PMCID: PMC7610173 DOI: 10.12688/f1000research.23469.1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2020] [Indexed: 12/17/2022] Open
Abstract
Cholecystitis is one of the leading causes of emergency surgical interventions; the occurrence of metastases to the gallbladder is rare and has only been reported in the literature exceptionally. Metastatic breast cancer to the gallbladder is even less frequent; in fact, breast cancer usually metastasizes to bone, lung, lymph nodes, liver and brain. We report the case of an 83-year-old female patient with a previous history of breast surgery with axillary dissection in 1997, followed by adjuvant chemotherapy due to invasive ductal carcinoma of the left breast. The patient was admitted at the emergency department for sepsis and an episode of acute kidney failure, anuria and fever. Right-upper quadrant abdominal pain triggered by food intake and abdominal tenderness was also present, placing the diagnostic suspicion of biliary sepsis due to acute cholecystitis. The histological examination of the surgical specimen highlighted the presence of metastasis from an infiltrating ductal breast carcinoma with positive hormone receptors. We also report here the results of a review of the literature looking at articles describing cases of gallbladder metastasis from breast cancer.
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Affiliation(s)
- Giulia Missori
- Department of General Surgery, University of Modena and Reggio Emilia, Modena, Italy, 41124, Italy
| | - Francesco Serra
- Department of General Surgery, University of Modena and Reggio Emilia, Modena, Italy, 41124, Italy
| | - Giorgia Prestigiacomo
- Department of General Surgery, University of Modena and Reggio Emilia, Modena, Italy, 41124, Italy
| | | | - Lucio Brugioni
- Department of Emergency Medicine, University Hospital Modena, Modena, Italy, 41124, Italy
| | - Roberta Gelmini
- Department of General Surgery, University of Modena and Reggio Emilia, Modena, Italy, 41124, Italy
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13
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Riano I, Paredes-Guarderas D, Mangano M. Gallbladder Metastasis From Cervical Human Papillomavirus-Related Squamous Cell Carcinoma Presenting as Acute Cholecystitis. JCO Oncol Pract 2020; 16:179-180. [PMID: 32048925 DOI: 10.1200/jop.19.00578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ivy Riano
- Department of Internal Medicine, MetroWest Medical Center, Framingham, MA
| | | | - Mark Mangano
- Department of Pathology, Milford Regional Medical Center, Milford, MA
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14
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Mouchli M, Grider DJ, Yeaton P. Gallbladder Metastases: A Report of Two Cases. Case Rep Oncol 2019; 12:235-240. [PMID: 31011322 PMCID: PMC6465751 DOI: 10.1159/000497818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 02/07/2019] [Indexed: 12/16/2022] Open
Abstract
Introduction Metastasis to the gallbladder is not common and usually manifests an advanced stage of malignancy. Herein, we report a case of triple negative high grade invasive ductal carcinoma of breast with a metastatic lesion to the gallbladder. Case Presentation The patient is a 52-year-old female diagnosed with invasive ductal carcinoma treated with mastectomy and chemotherapy. After 12 months, she presented to the emergency department with right upper quadrant pain and elevated liver chemistries. Abdominal enhanced computed tomography showed periportal and gallbladder wall edema. After cholecystectomy, the resected gallbladder was histologically considered to be a metastatic lesion arising from the primary lung cancer. The second case describes a case of a 77-year-old woman with multiple co-morbidities who presented to the hospital with sepsis secondary to biliary source. Abdominal enhanced computed tomography findings were concerning for acute cholecystitis. After cholecystectomy, the pathology of the resected gallbladder demonstrated cholecystitis and plasmacytoma. Conclusion The atypical presentation of gallbladder metastases could mislead treating providers. The diagnosis might alter management decisions and prognosis.
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Affiliation(s)
- Mohamad Mouchli
- Virginia Tech Carilion School of Medicine, Division of Gastroenterology and Hepatology, Roanoke, Virginia, USA
| | - Douglas J Grider
- Virginia Tech Carilion School of Medicine, Department of Basic Science Education, Roanoke, Virginia, USA
| | - Paul Yeaton
- Virginia Tech Carilion School of Medicine, Division of Gastroenterology and Hepatology, Roanoke, Virginia, USA
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15
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Muszynska C, Lundgren L, Andersson R, Søland T, Lindell G, Sandström P, Andersson B. Incidental metastases and lymphoma of the gallbladder - an analysis of ten rare cases identified from a large national database. Scand J Gastroenterol 2019; 54:350-358. [PMID: 31035806 DOI: 10.1080/00365521.2019.1588363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: The aim was to identify and characterize rare malignancies of the gallbladder, incidentally found at cholecystectomy, and describe the diagnostic work-up, treatment and outcome. Methods: Data from cholecystectomies during 2007-2014 registered in the Swedish Register for Gallstone Surgery (GallRiks) were analyzed for incidental cancer. For completion of the pathology report, data were linked with the Swedish Registry for Cancer in the liver and biliary tract (SweLiv) and/or the Swedish Cancer Registry. Results: From 36,355 patients that underwent cholecystectomy on a benign indication 215 cases of incidental gallbladder cancer (IGBC) were identified. In total seven patients with metastases to the gallbladder from different primary tumors (breast cancer, malignant melanoma, gastric cancer, renal cell carcinoma, upper gastrointestinal cancer, colon cancer and pancreatic cancer) and three patients with lymphoma involvement of the gallbladder were found. Most patients were female with no difference between the groups (8/10 versus 171/215). The median age for the metastasis and lymphoma (MOL) group was equal to the IGBC group, 70 (64-72) years versus 70 (63-78) years. All patients in the MOL group underwent preoperative imaging with ultrasound or computed tomography, on which no metastases were identified. In only two patients a tumor was seen by the surgeon during the perioperative examination of the gallbladder. The median survival was 5.8 months for MOL patients and 23 months for IGBC patients. Conclusion: Metastases and lymphoma of the gallbladder are rare. Traditional imaging methods prior to cholecystectomy may miss gallbladder malignancies. A liberal approach of histopathological analysis of the gallbladder should be applied.
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Affiliation(s)
- Carolina Muszynska
- a Department of Surgery , Skåne University Hospital , Lund , Sweden.,b Department of Clinical Sciences , Lund University , Lund , Sweden
| | - Linda Lundgren
- c Department of Surgery , County Council of Östergötland , Linköping , Sweden.,d Department of Clinical and Experimental Medicine, Faculty of Health Sciences , Linköping University , Linköping , Sweden
| | - Roland Andersson
- a Department of Surgery , Skåne University Hospital , Lund , Sweden.,b Department of Clinical Sciences , Lund University , Lund , Sweden
| | - Torunn Søland
- e Department of Pathology , Østfold Hospital , Norway
| | - Gert Lindell
- a Department of Surgery , Skåne University Hospital , Lund , Sweden.,b Department of Clinical Sciences , Lund University , Lund , Sweden
| | - Per Sandström
- c Department of Surgery , County Council of Östergötland , Linköping , Sweden.,d Department of Clinical and Experimental Medicine, Faculty of Health Sciences , Linköping University , Linköping , Sweden
| | - Bodil Andersson
- a Department of Surgery , Skåne University Hospital , Lund , Sweden.,b Department of Clinical Sciences , Lund University , Lund , Sweden
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Takahashi M, Yoshitomi H, Kato A, Furukawa K, Takayashiki T, Kuboki S, Takano S, Sugiura K, Kawasaki K, Miyazaki M, Ohtsuka M. A case of successfully resected metachronous gastric and gallbladder metastases from pancreatic body cancer. Surg Case Rep 2019; 5:21. [PMID: 30758733 PMCID: PMC6374494 DOI: 10.1186/s40792-019-0581-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 02/04/2019] [Indexed: 12/27/2022] Open
Abstract
Background Pancreatic ductal adenocarcinoma (PDAC) readily metastasizes to the lymph nodes, liver, lung, and peritoneum; however, gastric and gallbladder metastases are rare. We report a case of metachronous gastric and gallbladder metastases from PDAC. Case presentation The patient is a 71-year-old man who underwent distal pancreatectomy for PDAC. Seventeen months after the surgery, a 30-mm nodule was detected at the lesser curvature of the stomach, which was diagnosed as recurrence of PDAC in the lymph nodes. He then received gemcitabine and S-1 combination chemotherapy for 6 months. Because tumor size remained approximately the same and tumor marker levels decreased, total gastrectomy and cholecystectomy were performed. Pathological examination showed well-differentiated tubular adenocarcinoma in the subserosa and muscularis propria of the stomach and gallbladder. The patient remains alive at 41 months after the second surgery with liver metastasis. Conclusion We reported a rare case of metachronous gastric and gallbladder metastases from pancreatic body cancer.
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Affiliation(s)
- Makoto Takahashi
- Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Hideyuki Yoshitomi
- Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.
| | - Atsushi Kato
- Digestive Diseases Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Katsunori Furukawa
- Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Tsukasa Takayashiki
- Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Satoshi Kuboki
- Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Shigetsugu Takano
- Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Kensuke Sugiura
- Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Keishi Kawasaki
- Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Masaru Miyazaki
- Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.,Digestive Diseases Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Masayuki Ohtsuka
- Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
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17
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Zamkowski M, Kąkol M, Makarewicz W, Ropel J, Bobowicz M. Patient with metastatic breast cancer presenting as acute cholecystitis with one-year survival on hormonotherapy. POLISH JOURNAL OF SURGERY 2017; 89:46-49. [PMID: 28905808 DOI: 10.5604/01.3001.0010.4063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Breast cancer has high metastatic potential with distant metastases involving mainly lungs, liver and bones. Less frequently it gives distant spread to other organs. Herein we would like to present a very rare case of an acute cholecystitis which turned out to be a metastatic breast cancer in previously healthy woman. A female patient, 64-years old, presented to the emergency department with symptoms of biliary colic and acute abdomen. During the emergency cholecystectomy, we diagnosed the gallbladder empyema with thickened wall. There were also multiple metastatic nodules in the peritoneal cavity and an excessive amount of free fluid. The emergency physicians diagnosing female patient with the acute abdominal symptoms and a breast cancer history might suspect malignant spread into abdominal organs including gallbladder. On the other hand, acute cholecystitis symptoms might be the first symptoms of metastatic process in the gallbladder from the unknown primary source, which may be breast.
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Affiliation(s)
| | - Michał Kąkol
- Gdański Uniwersytet Medyczny; Katedra i Klinika Chirurgii Onkologicznej, Gdańsk, Polska Szpital Specjalistyczny w Kościerzynie, Kościerzyna, Polska
| | - Wojciech Makarewicz
- Department of General, Endocrinological and Transplant Surgery, Medical University, Gdańsk
| | - Jerzy Ropel
- Department of Surgery, Regional Health Center in Kartuzy, Poland
| | - Maciej Bobowicz
- Department of Oncological Surgery Medical University in Gdańsk
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18
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Shyr BU, Chen SC, Shyr YM, Lee RC, Wang SE. Metastatic polyp of the gallbladder from renal cell carcinoma. BMC Cancer 2017; 17:244. [PMID: 28376766 PMCID: PMC5379575 DOI: 10.1186/s12885-017-3243-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/29/2017] [Indexed: 12/28/2022] Open
Abstract
Background Gallbladder metastasis from renal cell carcinoma (RCC) is extremely rare. The purpose of this study is to clarify the characteristics of metastatic RCC to gallbladder. Methods The pooled data for analysis were collected from the case of metastatic RCC to gallbladder encountered by our institution along with sporadic cases reported in literature from 1991 to 2015. Results A total of 50 cases of metastatic RCC to gallbladder were recruited for study. Fifty-seven percentage of the primary RCC was from the right kidney and 43% from the left. The median interval between diagnoses of primary and metastatic RCC to gallbladder was 36 months, with the longest duration up to 324 months. Most (70%) were asymptomatic. The size of metastatic RCC to gallbladder ranged from 0.8 cm to 9 cm, with median of 2.6 cm. Majority (91%) of the metastatic RCCs presented as a polypoid mass with narrow stalk, and 82% were hypervascular lesion. The overall 1 year, 3 year and 5 year survival rate was 91.5%, 76.2% and 59.3% respectively, with a median of 26.5 months. Number of the metastatic site, timing of gallbladder metastasis, symptom, tumor size and operation type of cholecystectomy seemed to have no impact on survival. Conclusions Metastatic RCC to the gallbladder should be taken into account for a gallbladder polypoid mass with narrow hypervascular stalk during the diagnosis and/or follow-up of primary RCC. Gallbladder metastasis from RCC is not necessarily to be an advanced stage with poor outcome, and cholecystectomy is recommended whenever possible.
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Affiliation(s)
- Bor-Uei Shyr
- Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, 10 F 201 Section 2 Shipai Road, Taipei, 112, Taiwan
| | - Shih-Chin Chen
- Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, 10 F 201 Section 2 Shipai Road, Taipei, 112, Taiwan
| | - Yi-Ming Shyr
- Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, 10 F 201 Section 2 Shipai Road, Taipei, 112, Taiwan
| | - Rheun-Chuan Lee
- Departments of Radiology, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan
| | - Shin-E Wang
- Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, 10 F 201 Section 2 Shipai Road, Taipei, 112, Taiwan.
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19
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Mrak K, Lackner C, Mischinger HJ, Kornprat P. Metachronous gallbladder metastasis from renal cell carcinoma-a rare clinical manifestation. Wien Klin Wochenschr 2016; 128:669-71. [PMID: 27624324 DOI: 10.1007/s00508-016-1058-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 07/08/2016] [Indexed: 12/29/2022]
Abstract
Renal cell carcinoma (RCC) represents a rare tumor entity accounting for approximately 3 % of all malignancies in the adult population. Approximately 30 % of all patients suffering from RCC develop metastases after nephrectomy and another 30 % of patients suffer from synchronous metastases at the date of diagnosis. Gallbladder metastases represent an extremely rare clinical condition and up to date there are only 35 published cases of gallbladder metastasis from RCC. Surgical resection should be the treatment of choice in any case based on the reported data in literature. In spite of the small series of cases, survival can be improved even in patients suffering from additional sites of metastases.
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Affiliation(s)
- Karl Mrak
- Department of Surgery, Division of General Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria.
| | - Carolin Lackner
- Institute of Pathology, Medical University Of Graz, Graz, Austria
| | - Hans-Jörg Mischinger
- Department of Surgery, Division of General Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria
| | - Peter Kornprat
- Department of Surgery, Division of General Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria
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20
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Mellnick VM, Menias CO, Sandrasegaran K, Hara AK, Kielar AZ, Brunt EM, Doyle MBM, Dahiya N, Elsayes KM. Polypoid lesions of the gallbladder: disease spectrum with pathologic correlation. Radiographics 2016; 35:387-99. [PMID: 25763724 DOI: 10.1148/rg.352140095] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Gallbladder polyps are seen on as many as 7% of gallbladder ultrasonographic images. The differential diagnosis for a polypoid gallbladder mass is wide and includes pseudotumors, as well as benign and malignant tumors. Tumefactive sludge may be mistaken for a gallbladder polyp. Pseudotumors include cholesterol polyps, adenomyomatosis, and inflammatory polyps, and they occur in that order of frequency. The most common benign and malignant tumors are adenomas and primary adenocarcinoma, respectively. Polyp size, shape, and other ancillary imaging findings, such as a wide base, wall thickening, and coexistent gallstones, are pertinent items to report when gallbladder polyps are discovered. These findings, as well as patient age and risk factors for gallbladder cancer, guide clinical decision making. Symptomatic polyps without other cause for symptoms, an age over 50 years, and the presence of gallstones are generally considered indications for cholecystectomy. Incidentally noted pedunculated polyps smaller than 5 mm generally do not require follow-up. Polyps that are 6-10 mm require follow-up, although neither the frequency nor the length of follow-up has been established. Polyps that are larger than 10 mm are typically excised, although lower size thresholds for cholecystectomy may be considered for patients with increased risk for gallbladder carcinoma, such as patients with primary sclerosing cholangitis.
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Affiliation(s)
- Vincent M Mellnick
- From the Mallinckrodt Institute of Radiology (V.M.M.), Department of Pathology (E.M.B.), and Department of Surgery (M.B.M.D.),Washington University School of Medicine, 510 S Kingshighway Blvd, Box 8131, St Louis, MO 63110; Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M., A.K.H., N.D.); Department of Radiology, Indiana University School of Medicine, Indianapolis, Ind (K.S.); Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (A.Z.K.); and Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.)
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21
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Gallbladder's clear cell renal carcinoma metastasis: A case report. Int J Surg Case Rep 2015; 18:48-51. [PMID: 26688513 PMCID: PMC4701866 DOI: 10.1016/j.ijscr.2015.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 12/28/2022] Open
Abstract
Contribute to the comprehension of rare mestatic disease in clear cell renal carcinoma. Underline that non only primary tumors develop in the gallbladder. Increasing suspect of metastatic disease in patients with renal cell carcinoma will improve medical care of this patients.
Introduction Clear cell renal cell carcinoma (ccRCC) is well known for its propensity to metastasize to unusual sites, even after 10 years. Gallbladder metastases are extremely rare, being found in approximately 0.6% of cases, at autopsy. Case presentation A 51-year-old man with a history of right ccRCC underwent total nephrectomy with extended lymphadenectomy, in another Hospital. Three years later, he was hospitalized at our Hospital, with gallbladder metastasis detected during a follow-up CT scan. At clinical examination, the patient did not present any symptoms or signs of gallbladder disease. Several imaging tests were performed to better characterize the lesion. A successful cholecystectomy and hepatic resection of 4b segment were performed, obtaining a R0 resection. The clinical course was uneventful, without any complications. After a 7-month follow-up, the patient is free from disease. Discussion A typical metastases are those located in a site other than thoracic, skeletal, hepatic, adrenal or encephalic tissue. Cholecystectomy with R0 resection has demonstrated to be the only factor increasing survival, mainly in isolated cases of metastasis, providing an overall 35–60% survival rate at 5 years. Conclusion In the follow-up of patients with a positive history of renal cell carcinoma specially clear cell subtype, all new finding should be taken into account as possible metastases. We ought to consider US and CT-scan behavior of gallbladder metastatic disease in order to orientate our diagnosis. Surgery for metastatic gallbladder disease of renal origin seems to be a feasible therapy which is capable of increasing patients’ overall survival.
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22
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Choi WS, Kim SH, Lee ES, Lee KB, Yoon WJ, Shin CI, Han JK. CT findings of gallbladder metastases: emphasis on differences according to primary tumors. Korean J Radiol 2014; 15:334-45. [PMID: 24843238 PMCID: PMC4023052 DOI: 10.3348/kjr.2014.15.3.334] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 03/15/2014] [Indexed: 12/22/2022] Open
Abstract
Objective To describe computed tomography (CT) features of metastatic gallbladder (GB) tumors (MGTs) from various primary tumors and to determine whether there are differential imaging features of MGTs according to different primary tumors. Materials and Methods Twenty-one patients who had pathologically confirmed MGTs and underwent CT were retrospectively enrolled. Clinical findings including presenting symptoms, type of surgery, and interval between primary and metastatic tumors were recorded. Histologic features of primary tumor and MGTs including depth of invasion were also reviewed. Imaging findings were analyzed for the location and morphology of MGTs, pattern and degree of enhancement, depth of invasion, presence of intact overlying mucosa, and concordance between imaging features of primary and metastatic tumors. Significant differences between the histologies of MGTs and imaging features were determined. Results The most common primary tumor metastasized to the GB was gastric cancer (n = 8), followed by renal cell carcinoma (n = 4) and hepatocellular carcinoma (n = 3). All MGTs (n = 21) manifested as infiltrative wall thickenings (n = 15) or as polypoid lesions (n = 6) on CT, similar to the features of primary GB cancers. There were significant differences in the morphology of MGTs, enhancement pattern, enhancement degree, and depth of invasion according to the histology of primary tumors (p < 0.05). Metastatic adenocarcinomas of the GB manifested as infiltrative and persistently enhancing wall thickenings, while non-adenocarcinomatous metastases usually manifested as polypoid lesions with early wash-in and wash-out. Conclusion Although CT findings of MGTs are similar to those of primary GB cancer, they are significantly different between the various histologies of primary tumors.
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Affiliation(s)
- Won Seok Choi
- Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea
| | - Se Hyung Kim
- Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea
| | - Eun Sun Lee
- Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea
| | - Kyoung-Bun Lee
- Department of Pathology, Seoul National University Hospital, Seoul 110-744, Korea
| | - Won Jae Yoon
- Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul 100-032, Korea
| | - Cheong-Il Shin
- Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea
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23
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Contrast enhanced ultrasound of a gallbladder lesion in a patient with a history of renal cell and rectal cancer. Case Rep Gastrointest Med 2013; 2013:538534. [PMID: 23936689 PMCID: PMC3712251 DOI: 10.1155/2013/538534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 06/19/2013] [Indexed: 02/07/2023] Open
Abstract
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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24
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Jeong YS, Han HS, Lim SN, Kim MJ, Han JH, Kang MH, Ryu DH, Lee OJ, Lee KH, Kim ST. Gallbladder Metastasis of Non-small Cell Lung Cancer Presenting as Acute Cholecystitis. Chin J Cancer Res 2013; 24:249-52. [PMID: 23358590 DOI: 10.1007/s11670-012-0249-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Accepted: 06/28/2012] [Indexed: 12/19/2022] Open
Abstract
Although non-small cell lung cancer (NSCLC) can metastasize to almost any organ, metastasis to the gallbladder with significant clinical manifestation is relatively rare. Here, we report a case of gallbladder metastasis of NSCLC presenting as acute cholecystitis. A 79-year-old man presented with pain in the right upper quadrant and fever. A computed tomography (CT) scan of the chest and abdomen showed a cavitary mass in the right lower lobe of the lung and irregular wall thickening of the gallbladder. Open cholecystectomy and needle biopsy of the lung mass were performed. Histological examination of the gallbladder revealed a moderately-differentiated squamous cell carcinoma displaying the same morphology as the lung mass assessed by needle biopsy. Subsequent immunohistochemical examination of the gallbladder and lung tissue showed that the tumor cells were positive for P63 but negative for cytokeratin 7, cytokeratin 20 and thyroid transcription factor-1. A second primary tumor of the gallbladder was excluded by immunohistochemical methods, and the final pathological diagnosis was gallbladder metastasis of NSCLC. Although the incidence is extremely rare, acute cholecystitis can occur in association with lung cancer metastasis to the gallbladder.
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25
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Ghaouti M, Znati K, Jahid A, Zouaidia F, Bernoussi Z, El Fakir Y, Mahassini N. A gallbladder tumor revealing metastatic clear cell renal carcinoma: report of case and review of literature. Diagn Pathol 2013; 8:4. [PMID: 23305230 PMCID: PMC3546909 DOI: 10.1186/1746-1596-8-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 12/26/2012] [Indexed: 12/28/2022] Open
Abstract
Metastatic renal cell carcinoma in the gallbladder is extremely rare, with reported frequencies of less than 0.6% in large autopsy reviews. Only 40 cases were reported in the literature. We report a first case of gallbladder polypoid tumor revealing metastatic clear cell renal cell carcinoma, which demonstrates the importance of radiological tests, histology and immunohistochemistry when making a definitive diagnosis. These examinations also allow differentiating metastatic clear cell renal cell carcinoma from other polypoid lesions in the gallbladder with clear cell morphology. Cholecystectomy should be performed to obtain a definitive diagnosis and to improve survival in case of solitary metastatic renal cell carcinoma.
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Affiliation(s)
- Merieme Ghaouti
- Department of Pathology, Ibn Sina Univesity Hospital, Rabat, Morocco.
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26
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Robledo AB, Millet SB, Orbis Castellanos JF, Montalvá Orón EM, Salom Fuster JV, DE Juan Burgueño M. Metastasis of the gallbladder in clear cell renal carcinoma. Oncol Lett 2012; 3:1136-1138. [PMID: 22783406 DOI: 10.3892/ol.2012.616] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 01/17/2012] [Indexed: 12/21/2022] Open
Abstract
Metastasis of the gallbladder due to renal cell tumors is rare. We present a case of gallbladder and metachronous left adrenal metastasis at six months follow-up, which demonstrates the importance of radiological tests and histology when making a definitive diagnosis. Clinical findings are not specific enough to arrive at a final diagnosis. However, immunohistochemistry is necessary to differentiate between primary and secondary metastatic tumors. Cholecystectomy should be performed to obtain a definitive diagnosis and to improve survival in cases of single lesions in the gallbladder.
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27
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28
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Campbell N, Barrett S, Halpenny D, Tahir F, Manecksha RP, Feeney J, Hamilton S, Torreggiani WC. Imaging patterns of atypical renal cell carcinoma recurrence: a pictorial review. Can Assoc Radiol J 2010; 63:30-8. [PMID: 20828980 DOI: 10.1016/j.carj.2010.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 07/31/2010] [Accepted: 08/03/2010] [Indexed: 11/29/2022] Open
Affiliation(s)
- Naomi Campbell
- Department of Radiology, Adelaide and Meath Hospital incorporating The National Children's Hospital, Tallaght, Dublin, Ireland.
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29
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Khan ZS, Huth J, Kapur P, Huerta S. Indications and recommended approach for surgical intervention of metastatic disease to the gallbladder. World J Surg Oncol 2010; 8:80. [PMID: 20828420 PMCID: PMC2944133 DOI: 10.1186/1477-7819-8-80] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2010] [Accepted: 09/10/2010] [Indexed: 12/26/2022] Open
Abstract
Metastatic disease to the gallbladder is unusual. The most common malignancy metastatic to the gallbladder is melanoma, followed by renal cell carcinoma (RCC) and breast cancer. Due to the unusual nature of the disease, there are no trials available for review. Thus, the management for these patients has been based on institutional experience and review of case series. The indications for surgical intervention for melanoma are metastatic disease discrete to the gallbladder and biliary symptoms, which are uncommon for melanoma, but might occur due to cystic duct obstruction culminating in cholecystitis. Laparoscopic cholecystectomy without a lymphadenectomy is emerging as the preferred approach for this metastatic deposit. The vast majority of patients with metastases to the gallbladder from RCC carry a good prognosis and a laparoscopic cholecystectomy should be considered. Patients with metastases to the gallbladder from the breast classically present with biliary symptoms and commonly undergo a laparoscopic cholecystectomy, which invariably demonstrates a deposit in the gallbladder from lobular breast cancer. In the present report, we review the indications for surgical intervention from various malignancies metastatic to the gallbladder and the current consensus for the laparoscopic approach from the diverse metastatic deposits to the gallbladder.
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Affiliation(s)
- Zarrish S Khan
- Department of Surgery, UT Southwestern Medical Center, Harry Hines Blvd, Dallas, 75219, USA
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