Abstract
BackgroundRenal 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 PresentationThis 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.ConclusionsRCC 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 materialThe online version of this article (doi:10.1186/s12957-016-0843-3) contains supplementary material, which is available to authorized users.
Highlights
Renal cell carcinoma accounts for 90 % of renal neoplasms and metastatic disease is common
renal cell carcinoma (RCC) metastasis to the gallbladder is associated with an unusual pattern of concomitant metastasis
There was a predominance of male patients (67.3 %), and the median age at presentation of gallbladder metastasis was 62.5 years old
Summary
Renal cell carcinoma accounts for 90 % of renal neoplasms and metastatic disease is common. Thirty-six patients demonstrated metachronous gallbladder metastasis with median disease-free interval (DFI) from nephrectomy of 4 years. Latent distant metastasis is characteristic of renal cell carcinoma (RCC) and can manifest more than a decade after nephrectomy in about 10 % of patients [3]. Clear Cell (CC) RCC is the most common type of renal cancer, accounting for 75 % of all primary kidney tumours. Similar to sarcomas, can occur in all types of RCC but is most often seen in clear cell and chromophobe RCC [5] These patients have an adverse stage stratified prognosis with a median survival of 4–19 months [6]
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