Shyr Bor-Uei, Chen Shih-Chin, Shyr Yi-Ming, Lee Rheun-Chuan, Wang Shin-E
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, 10 F 201 Section 2 Shipai Road, Taipei, 112, Taiwan.
Departments of Radiology, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan.
BMC Cancer. 2017 Apr 4;17(1):244. doi: 10.1186/s12885-017-3243-3.
Gallbladder metastasis from renal cell carcinoma (RCC) is extremely rare. The purpose of this study is to clarify the characteristics of metastatic RCC to gallbladder.
The pooled data for analysis were collected from the case of metastatic RCC to gallbladder encountered by our institution along with sporadic cases reported in literature from 1991 to 2015.
A total of 50 cases of metastatic RCC to gallbladder were recruited for study. Fifty-seven percentage of the primary RCC was from the right kidney and 43% from the left. The median interval between diagnoses of primary and metastatic RCC to gallbladder was 36 months, with the longest duration up to 324 months. Most (70%) were asymptomatic. The size of metastatic RCC to gallbladder ranged from 0.8 cm to 9 cm, with median of 2.6 cm. Majority (91%) of the metastatic RCCs presented as a polypoid mass with narrow stalk, and 82% were hypervascular lesion. The overall 1 year, 3 year and 5 year survival rate was 91.5%, 76.2% and 59.3% respectively, with a median of 26.5 months. Number of the metastatic site, timing of gallbladder metastasis, symptom, tumor size and operation type of cholecystectomy seemed to have no impact on survival.
Metastatic RCC to the gallbladder should be taken into account for a gallbladder polypoid mass with narrow hypervascular stalk during the diagnosis and/or follow-up of primary RCC. Gallbladder metastasis from RCC is not necessarily to be an advanced stage with poor outcome, and cholecystectomy is recommended whenever possible.
肾细胞癌(RCC)转移至胆囊极为罕见。本研究旨在阐明RCC转移至胆囊的特征。
分析汇总的数据来自本院遇到的RCC转移至胆囊的病例以及1991年至2015年文献报道的散发病例。
共纳入50例RCC转移至胆囊的病例进行研究。原发RCC中57%来自右肾,43%来自左肾。原发RCC与RCC转移至胆囊的诊断间隔中位数为36个月,最长达324个月。大多数(70%)无症状。RCC转移至胆囊的大小为0.8 cm至9 cm,中位数为2.6 cm。大多数(91%)转移的RCC表现为带窄蒂的息肉样肿块,82%为富血管病变。总体1年、3年和5年生存率分别为91.5%、76.2%和59.3%,中位数为26.5个月。转移部位数量、胆囊转移时间、症状、肿瘤大小及胆囊切除手术方式似乎对生存率无影响。
在原发性RCC的诊断和/或随访过程中,对于带窄蒂富血管的胆囊息肉样肿块,应考虑RCC转移至胆囊的可能。RCC转移至胆囊不一定处于晚期且预后不良,尽可能建议行胆囊切除术。