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.
Highlights
IntroductionRenal cell carcinoma (RCC) represents the ninth most common malignancy in Europe, clear cell carcinoma being the main histological type (80% to 90%),[1] The gallbladder is a rare site of distant metastases
The only curative therapeutic approach for renal cell carcinoma (RCC) is surgery
Renal cell carcinoma (RCC) represents the ninth most common malignancy in Europe, clear cell carcinoma being the main histological type (80% to 90%),[1] The gallbladder is a rare site of distant metastases
Summary
Renal cell carcinoma (RCC) represents the ninth most common malignancy in Europe, clear cell carcinoma being the main histological type (80% to 90%),[1] The gallbladder is a rare site of distant metastases. We report 2 cases of gallbladder metastasis from clear cell RCC that were treated by laparoscopic cholecystectomy. The gallbladder polypoid mass increased in size from the initial 1.5 cm to 3.0 cm diameter 12 months later on follow-up imaging (Figures 1 and 2), and the patient developed right upper quadrant pain. A follow-up computed tomography scan of chest/abdomen/pelvis showed a solitary suspect 15-mm nodule in the gallbladder (Figure 4). It clearly increased in size 8 weeks later, when ultrasound scan (Figure 5) showed a polypoid lesion in the fundus measuring 30 mm, hypervascularized on Doppler sonography. Histopathological analysis showed a polypoid tumor of 2.2 × 2.0 cm in the gallbladder fundus representing RCC metastasis with clear cell type cells and abundant vascularization in the stroma (Figure 7). The postoperative course was uneventful and the patient is recurrence free at 55-month follow-up without any additional therapy
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