Figure - available from: Case Reports in Gastrointestinal Medicine
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Histological examination of the gallbladder (hematoxylin eosin, (a) 100x and (b) 200x) showing metastatic clear cell renal cell carcinoma within the mucosa of the the gallbladder wall. The mucosa of the gallbladder wall is marked with an asterisk in (b).
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The gallbladder is an uncommon site of metastatic cancer. Although ultrasound can be regarded as a first line investigation for the detection of gallbladder lesions, differentiation between benign and malignant tumors usually requires resection. Real-time contrast enhanced ultrasound (CEUS) is a well-established technique for the classification of...
Citations
... Abdominal ultrasound is a convenient and reliable tool in the diagnosis of gallbladder tumors. Metastases can appear as hyperechoic masses bigger than 1 cm in diameter, close to the gallbladder wall without posterior acoustic shadowing [9][10][11][12]. A CT sign that can help in the differentiation between primary gallbladder tumors and metastases is the invasion of the mucosal layer. ...
... Ultrasonography (US) generally is the first diagnostic tool in gallbladder tumors. Metastases can appear under different hyperechoic masses bigger than 1cm in diameter, close to the gallbladder wall without posterior acoustic shadowing [49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] . Color-Doppler is an important complementary technique since the detection of flow signals rules out biliary sludge and cholesterol polyps, and indicates an expansive lesion [42] . ...
Renal cell carcinoma (RCC) represents 2% of all cancers, being the clear cell subtype the most common among renal tumors (70-80%). RCC is well known for its capacity to metastasize in an early stage of the disease, gallbladder metastases are considered extremely rare. The symptomatology goes from asymptomatic to cholecystitis like-symptoms. Ultrasonography, may be often, the first diagnostic tool, tumors can appear under different hyperechoic masses without acoustic shadowing. Metastasectomy has gained a wide consensus because of the possibility of extending survival, keeping in mind the importance of selection of the ideal candidate for it. The surgical procedure will be chosen upon the extend of the disease, it may go from a simple cholecystectomy to a cholecystectomy associated with a wedge/right hepatic lobectomy for curative purposes. We performed a systematic review of 77 cases of gallbladder's clear cell renal cell carcinoma metastasis published from 1963 up to date, analyzing the symptomatology at presentation, diagnosis, treatment, prognosis, and surgical procedures.
... Thus, gallbladder tumors have non-specific features on CT. Reiser et al wrote that it is difficult for CT and MRI to differentiate between benign and malignant gallbladder tumors [14]. Secondary gallbladder cancer is very rare, with the most frequent primary sources being malignant melanoma, colon, breast and pancreas [15]. ...
A 62-year-old male presented to the ER with three episodes of diffuse abdominal pain which occurred after eating. He had a history of renal cell carcinoma (RCC), prostate cancer and bladder cancer. FDG-PET/CT scan showed a hypermetabolic soft tissue density within the fundus of the gallbladder. The patient underwent laparoscopic cholecystectomy and surgical pathology revealed clear cell type RCC. This is the first report that features PET/CT imaging to detect RCC metastasis to the gallbladder. Lesions within the gall bladder and their clinical manifestations can be non-specific and PET/CT can help characterize them. RCC metastasis to the gallbladder is very rare but it should be included in the differential diagnosis, especially in patients with a history of RCC.
