Isolated metastasis to the gallbladder from hepatocellular carcinoma.
OBJECTIVE
Metastasis to gallbladder (GB) from hepatocellular carcinoma (HCC) is rare, and it is difficult to determine indications for surgery. We report eight cases of synchronous isolated GB metastasis, and analyze their features retrospectively.


METHODS
Among 439 HCC patients who underwent hepatectomy from 1998 to 2008 at our institution, 393 (89.5%) underwent concurrent cholecystectomy.


RESULTS
Among them, eight (1.8%) had GB metastasis without other distant metastases. None of these cases showed evidence of direct invasion. All cases had advanced portal vein thrombus (PVTT) and their main tumor located near the GB bed. Five cases had apparent tumor mass in the GB wall, and the other three cases had only tumor thrombus in the GB veins. Six cases were treated postoperatively with local infusion therapy with interferon, and three of them showed long-term survival.


CONCLUSIONS
Our eight cases of GB metastasis from HCC were closely related to PVTT. Surgical resection and multimodal treatment would be necessary for long-term survival in cases with isolated GB metastasis.
Murakami
Masahiro
M
Department of Surgery Graduate School of Medicine, Osaka University, 2-2 Yamadaoka E-2, Suita, 565-0871, Osaka, Japan.
Kobayashi
Shogo
S
Marubashi
Shigeru
S
Eguchi
Hidetoshi
H
Takeda
Yutaka
Y
Tanemura
Masahiro
M
Wada
Hiroshi
H
Umeshita
Koji
K
Kennichi
Wakasa
W
Doki
Yuichiro
Y
Mori
Masaki
M
Nagano
Hiroaki
H