Late metastasis of a clear-cell renal cell carcinoma in the gallbladder as a possible cause of acute cholecystitis: a case report

Abstract

Background: Gallbladder metastasis from renal cell carcinoma (RCC) is extremely rare. Case Presentation: We present a case of metastasis of clear cell carcinoma to the gallbladder, mimicking acute cholecystitis on clinical exam, in an 80-year-old man 24 years after radical nephrectomy. Ultrasound showed an image compatible with acute cholecystitis with sludge in the gallbladder. An elective cholecystectomy was performed with an uneventful postoperative course. Histopathologic examination revealed a metastasis of clear-cell renal cell carcinoma. The clinical presentation of acute cholecystitis can mask an RCC metastasis to the gallbladder, even several years after initial nephrectomy. This makes qualitative anatomopathological examination essential, especially with a neoplasia in the medical history. Gallbladder metastasis from RCC is not necessarily linked to a poor outcome. A cholecystectomy is recommended whenever possible. Conclusion: This case highlights the importance of considering metastatic disease in the differential diagnosis of gallbladder masses and acute cholecystitis, even in patients with a history of treated primary tumors.