A gallbladder tumor revealing metastatic clear cell renal carcinoma: report of case and review of literature

Merieme Ghaouti,Zakiya Bernoussi,Kaoutar Znati,Youssef El Fakir,Ahmed Jahid,Najat Mahassini,Fouad Zouaidia

doi:10.1186/1746-1596-8-4

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.Virtual slidesThe virtual slides’ for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8956897238238989

Highlights

Metastatic tumors to the gallbladder are uncommon
We report a case of intraluminal polypoid metastasis of clear cell renal cell carcinoma in gallbladder mimicking gallbladder polyp and revealing the renal carcinoma and reviewed the reported 40 cases
In summary, we report a case of a free-floating intraluminal polyp of the gallbladder consistent with a metastatic clear cell RCC and reviewed the 40 published cases on metastatic renal cell carcinoma in the gallbladder in the literature

Summary

Background

Metastatic tumors to the gallbladder are uncommon. The most common metastatic tumors to the gallbladder are metastatic melanomas and metastatic carcinomas from stomach, pancreas, ovary, bile ducts, colon and breast [1]. Diagnosis of metastatic renal cell carcinoma (RCC) was Figure 2 Axial computed tomography image after intravenous contrast enhancement shows a cortical fleshy nodule of the right kidney with no involvement of the perinephric adipose. Confirmed by immunohistochemical stains, which showed the tumor cells to be positive for CD10 (Figure 5), vimentin (Figure 6) and pancytokeratin, but negative for CK7, carcinoembryonic antigen (CEA), chromogranin, synaptophysin and CD68. In light of these new data, the patient was transferred to the department of Urology for a possible nephrectomy. The histological study revealed a typical conventional clear cell RCC, Fuhrman nuclear grade 3, with negative surgical resection margins (Figure 7)

Findings

Discussion

Conclusion