Metastasis of the gallbladder in clear cell renal carcinoma

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.

Figure 1

Ultrasonography image. Heterogeneous nodule attached to the gallbladder wall without posterior echogenic shadowing, with well-defined edges and adjacent wall thickening.

Figure 2

(A) Computed tomography (CT) image of a heterogeneous 2–3 cm nodule in the gallbladder with intense uptake in the arterial phase. (B) CT image of a hypervascular nodule in the left adrenal gland.

Figure 3

(A) Exophytic and polypoid lesion of 2.3×1.8 cm in the gallbladder. (B) Immunohistochemical technique of vimentin staining. The vimentin usually stains in the mesenchyme, but in clear cell renal carcinoma this staining occurs in the cytoplasm of tumor cells.