A Case of Gallbladder Metastasis from a Renal Cell Carcinoma Presenting with Gallbladder Hemorrhage

Abstract

A 61-year-old man who had undergone a right nephrectomy 7 years earlier for a right renal cell carcinoma was under clinical follow-up at the urology department of our hospital. In the history of present illness, the patient was admitted to our hospital's emergency department complaining of acute upper abdominal pain. CT was performed, because physical examination revealed tenderness in the epigastric region；the plain CT revealed a high-density region, believed to be caused by bleeding, in the gallbladder region and contrast-enhanced CT revealed early-phase staining of a tumor measuring 14mm in diameter. The patient was diagnosed as having bleeding from a gallbladder tumor. Open cholecystectomy was performed to treat the hemorrhagic gallbladder tumor. The resected gallbladder contained a dark red fluid composed of coagulated blood mixed with bile and a gallbladder tumor measuring 18mm in diameter. The tumor base could not be determined by the naked eye. Histopathological findings were consistent with a metastasis of clear cell carcinoma, which had been diagnosed in the past. We report this case here, because gallbladder metastases from renal cell carcinoma are hypervascular tumors and can therefore cause acute abdominal conditions such as biliary obstruction due to gallbladder bleeding or acute cholecystitis.