Department of Surgery.
Department of Urology.
Medicine (Baltimore). 2021 Jan 22;100(3):e24037. doi: 10.1097/MD.0000000000024037.
Gallbladder polyps are common in the general population, but gallbladder metastasis of renal cell carcinoma (RCC) is very rare. In a patient with RCC diagnosed with a small gallbladder polyp that does not meet the traditional size criteria, the surgeon faces a dilemma of whether cholecystectomy should be performed given the possibility of metastasis.
A 55-year-old man who had received a left nephrectomy for RCC presented with a gallbladder polyp that was noted at the time of the nephrectomy. Imaging showed the maximum diameter of the polyp had increased from 5 mm to 24 mm in the 40 months after the initial diagnosis.
Pathological and immunohistology findings confirmed the gallbladder polyp as a metastasis of clear-cell RCC.
: We performed a laparoscopic cholecystectomy.
Even though the synchronous solitary gallbladder metastasis was left untreated and a cholecystectomy was not performed over the 40 months, no metastasis occurred in other sites. The patient is free from disease 10 months after the cholecystectomy.
Solitary gallbladder metastasis of RCC may have more favorable outcomes than typical metastases. Although gallbladder metastasis of RCC occur rarely, it can occur, and any changes in gallbladder polyps in RCC patients should be managed under a strong suspicion of metastasis.
胆囊息肉在普通人群中较为常见，但胆囊转移的肾细胞癌（RCC）则非常罕见。在诊断为 RCC 的患者中，若胆囊内存在直径较小的息肉且不符合传统大小标准，外科医生在考虑是否进行胆囊切除术时，可能会面临转移的风险。
一位 55 岁男性，曾因 RCC 接受左肾切除术，在左肾切除术后发现胆囊息肉。影像学检查显示，在初始诊断后的 40 个月内，息肉的最大直径从 5 毫米增加到 24 毫米。
病理和免疫组化检查结果证实胆囊息肉为透明细胞 RCC 的转移。
我们进行了腹腔镜胆囊切除术。
尽管同步发生的孤立性胆囊转移未得到治疗，且在 40 个月内未进行胆囊切除术，但其他部位未发生转移。患者在胆囊切除术后 10 个月无疾病。
RCC 的孤立性胆囊转移可能比典型转移具有更好的预后。尽管 RCC 的胆囊转移很少见，但仍可能发生，对于 RCC 患者胆囊息肉的任何变化都应强烈怀疑转移。
