A Case of Gallbladder Metastasis from Renal Cell Carcinoma Resected 4 Years after Nephrectomy

Abstract

The patient was a 66-year-old man who had undergone left nephrectomy for left renal cancer four years previously. The pathological diagnosis was clear cell renal cell carcinoma (RCC). Three years after the surgery, a gallbladder polypoid tumor was detected using routine computed tomography. As the size of the tumor increased, laparoscopic cholecystectomy was performed. The specimen was a subpedunculated tumor with a diameter of 17 mm. The histological type of the tumor was clear cell carcinoma ; CD10 and PAX8 were positive, whereas CK7 and CEA were negative, on immunohistochemical staining. We diagnosed the tumor as an RCC metastasis. The patient is alive without recurrence 3.5 years after the cholecystectomy.

In general, RCC tends to metastasize to the lungs, liver, and bones ; gallbladder metastasis is rare. Gallbladder metastasis accounts for less than 1% of all RCC metastases. Only 45 cases have been reported in Japan, and some patients have survived long after cholecystectomy. When a patient with a history of RCC has a gallbladder tumor, the possibility of a metastatic RCC tumor should be considered.