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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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Saito Y, Okuda H, Yoshida M, Okimasa S, Fukuda T, Yano M, Ochi M, Okamoto Y, Nakayama H, Ono E, Ohdan H. Gallbladder metastasis of renal clear cell carcinoma 15 years after primary cancer excision: a case report. J Med Case Rep 2018; 12:162. [PMID: 29855393 PMCID: PMC5977495 DOI: 10.1186/s13256-018-1569-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/10/2018] [Indexed: 11/17/2022] Open
Abstract
Background Renal cell carcinoma is well-known for its propensity to metastasize to unusual sites. However, metastasis to the gallbladder has been rarely reported in the literature. Case presentation A 75-year-old Japanese (Asian) woman presented for further evaluation of a gallbladder polyp, 15 years after right radical nephrectomy for renal cell carcinoma. Computed tomography revealed a 12 mm enhancing pedunculated tumor in the gallbladder fundus. Open simple cholecystectomy was performed and the tumor was histologically confirmed as a metastasis of renal cell carcinoma to the gallbladder. Our patient is alive and has been disease-free for 3 years after cholecystectomy. Conclusions Although metastasis of renal cell carcinoma is a rare differential diagnosis of gallbladder tumors, simple cholecystectomy is likely to offer a chance of long-term survival for patients with gallbladder metastases of renal cell carcinoma.
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Affiliation(s)
- Yasufumi Saito
- Department of Surgery, Medical Corporation JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima, 732-0057, Japan.
| | - Hiroshi Okuda
- Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan
| | - Makoto Yoshida
- Department of Surgery, Medical Corporation JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima, 732-0057, Japan
| | - Seiji Okimasa
- Department of Palliative Care, Medical Corporation JR Hiroshima Hospital, Hiroshima, Japan
| | - Toshikatsu Fukuda
- Department of Surgery, Medical Corporation JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima, 732-0057, Japan
| | - Masatsugu Yano
- Department of Surgery, Medical Corporation JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima, 732-0057, Japan
| | - Makoto Ochi
- Department of Dialysis Surgery, Medical Corporation JR Hiroshima Hospital, Hiroshima, Japan
| | - Yuzo Okamoto
- Department of Surgery, Medical Corporation JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima, 732-0057, Japan
| | - Hirofumi Nakayama
- Department of Pathology and Laboratory Medicine, Medical Corporation JR Hiroshima Hospital, Hiroshima, Japan
| | - Eiji Ono
- Department of Surgery, Medical Corporation JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima, 732-0057, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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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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Costa Neves M, Neofytou K, Giakoustidis A, Hazell S, Wotherspoon A, Gore M, Mudan S. Two cases of gallbladder metastasis from renal cell carcinoma and review of literature. World J Surg Oncol 2016; 14:87. [PMID: 27005674 PMCID: PMC4802731 DOI: 10.1186/s12957-016-0843-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 03/10/2016] [Indexed: 12/29/2022] Open
Abstract
Background Renal cell carcinoma accounts for 90 % of renal neoplasms and metastatic disease is common. One third of newly diagnosed cases will have synchronous metastases at diagnosis and further 25–50 % will develop metachronous disease. Case Presentation This study presents two new cases of gallbladder metastasis from renal cell carcinoma (RCC) from our institution and reviews the published literature. The final cohort included 52 evaluable patients. M/F ratio was 2:1 and median age was 62.5 years. Most patients were diagnosed incidentally after follow-up or staging imaging for RCC. Of the patients with available histology, all except one were clear cell type (n = 39) and 92 % were polypoid. Thirty-six patients demonstrated metachronous gallbladder metastasis with median disease-free interval (DFI) from nephrectomy of 4 years. The most frequent site of metastasis was the contralateral kidney (46.7 %) followed by the pancreas and lung. The median disease-free interval (DFS) after cholecystectomy was 37 months. Three- and five-year OS rates were 74 and 62 %, respectively. Age younger than 45 years (p = 0.008) and DFI <24 months (p = 0.049) were associated with decreased OS. Conclusions RCC metastasis to the gallbladder is associated with an unusual pattern of concomitant metastasis. Symptoms are not common. Simple cholecystectomy is associated with increased OS and nil local or port site recurrence. Young age and short DFI are associated with decreased OS. Electronic supplementary material The online version of this article (doi:10.1186/s12957-016-0843-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mafalda Costa Neves
- Academic Surgery Department, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK. .,Surgery Department, The London Clinic, 116 Harley Street, London, W1G 7JL, UK.
| | - Kyriakos Neofytou
- Academic Surgery Department, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | | | - Stephen Hazell
- Pathology Department, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | - Andrew Wotherspoon
- Pathology Department, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | - Martin Gore
- Urology Department, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | - Satvinder Mudan
- Academic Surgery Department, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK.,Surgery Department, The London Clinic, 116 Harley Street, London, W1G 7JL, UK.,Department of Surgery and Cancer-Faculty of Medicine, Imperial College London, London, W2 1PG, UK
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5
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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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Win AZ, Aparici CM. Clinical effectiveness of (18)f-fluorodeoxyglucose positron emission tomography/computed tomography in management of renal cell carcinoma: a single institution experience. World J Nucl Med 2015; 14:36-40. [PMID: 25709543 PMCID: PMC4337006 DOI: 10.4103/1450-1147.150535] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Positron emission tomography (PET) is currently the most advanced technique of metabolic imaging available for tumor diagnosis and follow-up. The aim of this study was to examine the versatility and accuracy of fluorodeoxyglucose (FDG) PET/computed tomography (CT) in the metastasis detection of renal cell carcinoma (RCC). We also compared our findings to other similar studies from the literature. This is the biggest study so far to examine the sensitivity and specificity of FDG PET/CT in the management of RCC. A retrospective review was carried out on all the FDG PET/CT studies done from January 1999 to January 2014 at our institution. Biopsy results were considered the gold standard. For our patients (n = 315) with biopsy results, FDG PET/CT studies exhibited 100% sensitivity, 100% specificity. Our results were better than results achieved by other studies. The use of FDG PET/CT in restaging and metastasis detection of RCC has many advantages, in addition to high accuracy. This imaging technique has great potential in influencing treatment decisions. We recommend the incorporation of FDG PET/CT in routine standard protocols for RCC.
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Affiliation(s)
- Aung Zaw Win
- Department of Radiology, San Francisco VA Medical Center, San Francisco, CA 94121, USA
| | - Carina Mari Aparici
- Department of Radiology, San Francisco VA Medical Center, San Francisco, CA 94121, USA ; Department of Radiology, University California San Francisco, San Francisco, CA 94143, USA
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Ueda I, Aoki T, Oki H, Takahashi H, Hayashida Y, Minagawa N, Yamaguchi K, Fujimoto N, Matsumoto T, Yamada S, Korogi Y. Gallbladder metastasis from renal cell carcinoma: a case report with review of the literature. Magn Reson Med Sci 2014; 14:133-8. [PMID: 25345408 DOI: 10.2463/mrms.2013-0130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We experienced a rare case of gallbladder metastasis from renal cell carcinoma (RCC). Ultrasound, computed tomographic, and magnetic resonance findings showed a hypervascular polypoid mass and correlated well with histopathologic findings. The mass showed high intensity on diffusion-weighted images, and the apparent diffusion coefficient was relatively low. These imaging findings are considered characteristic and may assist preoperative diagnosis in patients with history of RCC.
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Affiliation(s)
- Issei Ueda
- Department of Radiology, University of Occupational and Environmental Health School of Medicine
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8
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Win AZ. Renal Cell Carcinoma Metastasis to the Gallbladder Detected by FDG-PET/CT. J Clin Med Res 2014; 6:482-6. [PMID: 25247024 PMCID: PMC4169092 DOI: 10.14740/jocmr1886w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2014] [Indexed: 12/17/2022] Open
Abstract
A 62-year-old male presented to the ER with three episodes of diffuse abdominal pain which occurred after eating. He had a history of renal cell carcinoma (RCC), prostate cancer and bladder cancer. FDG-PET/CT scan showed a hypermetabolic soft tissue density within the fundus of the gallbladder. The patient underwent laparoscopic cholecystectomy and surgical pathology revealed clear cell type RCC. This is the first report that features PET/CT imaging to detect RCC metastasis to the gallbladder. Lesions within the gall bladder and their clinical manifestations can be non-specific and PET/CT can help characterize them. RCC metastasis to the gallbladder is very rare but it should be included in the differential diagnosis, especially in patients with a history of RCC.
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Affiliation(s)
- Aung Zaw Win
- Department of Radiology, San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA.
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Hisa T, Takamatsu M, Shimizu T, Gibo N. Chronological changes in the ultrasonic findings of gallbladder metastasis from renal cell carcinoma: a case report and review. J Med Ultrason (2001) 2014; 41:371-5. [PMID: 27277913 DOI: 10.1007/s10396-013-0510-z] [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] [Received: 05/10/2013] [Accepted: 10/24/2013] [Indexed: 10/25/2022]
Abstract
The present case involves a gallbladder metastasis from renal cell carcinoma (GBMRCC). During 11 months of ultrasound follow-up examinations, the mass, covered with a highly echoic surface layer, exhibited the following changes: the wide base became constricted, the tumor surface became irregular, and the mass increased in diameter. A histopathological examination confirmed that the tumor cells were mainly present in the subepithelial layer, the gallbladder epithelium had ruptured, and necrotic debris covered the tumor surface. The highly echoic surface layer observed on the latest ultrasound images corresponded to the necrotic debris. These findings suggested that GBMRCCs initially develop in the subepithelial layer and then undergo expansive intraluminal growth. They subsequently cause the epithelium to rupture, resulting in necrotic debris appearing on the tumor surface.
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Affiliation(s)
- Takeshi Hisa
- Department of Internal Medicine, Saku Central Hospital, Usuda 197, Saku, Nagano, 384-0301, Japan.
| | - Masato Takamatsu
- Department of Internal Medicine, Saku Central Hospital, Usuda 197, Saku, Nagano, 384-0301, Japan
| | - Takehiro Shimizu
- Department of Internal Medicine, Saku Central Hospital, Usuda 197, Saku, Nagano, 384-0301, Japan
| | - Noriaki Gibo
- Department of Internal Medicine, Saku Central Hospital, Usuda 197, Saku, Nagano, 384-0301, Japan
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10
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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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Seeliger B, Callari C, Diana M, Mutter D, Marescaux J. Polypoid Gallbladder Lesion in the Context of Renal Cell Carcinoma: Is Laparoscopic Cholecystectomy a Reasonable Option? J Investig Med High Impact Case Rep 2013; 1:2324709613499008. [PMID: 26425579 PMCID: PMC4586817 DOI: 10.1177/2324709613499008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction. The only curative therapeutic approach for renal cell carcinoma (RCC) is surgery. Laparoscopic surgery for RCC has become an established surgical procedure with equivalent cancer-free survival rate, following the same surgical oncological principles as open surgery. Metastatic RCC of the gallbladder is a rare phenomenon. Hence, there are few reports regarding their management. Case Presentation. We report 2 cases of gallbladder metastasis from clear cell RCC treated by laparoscopic cholecystectomy. The first case was that of a 44-year-old male patient who underwent palliative cholecystectomy, the second case was that of an 83-year-old female patient who is doing well 55 months after surgery without evidence of disease recurrence. Conclusion. The outcome allows us to demonstrate the interest of surgical resection of RCC metastases in the gallbladder by laparoscopic cholecystectomy, respecting surgical oncological principles. Laparoscopic resection of an uncommon gallbladder metastasis can provide long-term favorable outcome.
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Affiliation(s)
| | | | - Michele Diana
- University Hospital of Strasbourg, Strasbourg, France
| | - Didier Mutter
- University Hospital of Strasbourg, Strasbourg, France
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12
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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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13
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Zevallos Quiroz JC, Lizarazu Pérez A, Guisasola Gorrochategui E, Medrano Gomez MÁ, Jiménez Agüero R. [Gallbladder metastasis from renal cell carcinoma, an extremely rare neoplastic dissemination location]. Cir Esp 2012; 92:295-6. [PMID: 22647566 DOI: 10.1016/j.ciresp.2012.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 02/14/2012] [Indexed: 10/28/2022]
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14
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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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