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Case Reports
. 2016 Mar 22:14:87.
doi: 10.1186/s12957-016-0843-3.

Two cases of gallbladder metastasis from renal cell carcinoma and review of literature

Mafalda Costa Neves  1   2 , Kyriakos Neofytou  3 , Alexandros Giakoustidis  4 , Stephen Hazell  5 , Andrew Wotherspoon  5 , Martin Gore  6 , Satvinder Mudan  3   4   7
Affiliations
Case Reports

Two cases of gallbladder metastasis from renal cell carcinoma and review of literature

Mafalda Costa Neves et al. World J Surg Oncol. .

Abstract

Background: Renal 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 presentation: This 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.

Conclusions: RCC 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.

Keywords: Cancer; Clear cell metastatic renal cell carcinoma; Gallbladder; Kidney neoplasms.

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Figures

Fig. 1
Fig. 1
Gallbladder specimen in low (a) and high-power field (b) showing the polyp confined to the gallbladder and composed of large nests and sheets of moderately sized polygonal cells with delicate cell borders and clear cytoplasm
Fig. 2
Fig. 2
Kaplan-Meier curve of disease-free survival (DFS) and overall survival (OS)
Fig. 3
Fig. 3
Disease-free survival (DFI) between nephrectomy and diagnosis of gallbladder metastasis and overall survival (OS) in patients with metachronous gallbladder metastasis
Fig. 4
Fig. 4
Age at diagnosis of gallbladder metastasis and overall survival (OS)
See this image and copyright information in PMC

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