title: Gallbladder's clear cell renal carcinoma metastasis: A case report.
abstract: BACKGROUND
  Clear cell renal cell carcinoma (ccRCC) is well known for its propensity to metastasize to unusual sites, even after 10 years. Gallbladder metastases are extremely rare, being found in approximately 0.6% of cases, at autopsy.
  
  
  METHODS
  A 51-year-old man with a history of right ccRCC underwent total nephrectomy with extended lymphadenectomy, in another Hospital. Three years later, he was hospitalized at our Hospital, with gallbladder metastasis detected during a follow-up CT scan. At clinical examination, the patient did not present any symptoms or signs of gallbladder disease. Several imaging tests were performed to better characterize the lesion. A successful cholecystectomy and hepatic resection of 4b segment were performed, obtaining a R0 resection. The clinical course was uneventful, without any complications. After a 7-month follow-up, the patient is free from disease.
  
  
  CONCLUSIONS
  A typical metastases are those located in a site other than thoracic, skeletal, hepatic, adrenal or encephalic tissue. Cholecystectomy with R0 resection has demonstrated to be the only factor increasing survival, mainly in isolated cases of metastasis, providing an overall 35-60% survival rate at 5 years.
  
  
  CONCLUSIONS
  In the follow-up of patients with a positive history of renal cell carcinoma specially clear cell subtype, all new finding should be taken into account as possible metastases. We ought to consider US and CT-scan behavior of gallbladder metastatic disease in order to orientate our diagnosis. Surgery for metastatic gallbladder disease of renal origin seems to be a feasible therapy which is capable of increasing patients' overall survival.
authors.affiliation: Chirurgia I a prevalente indirizzo Oncologico Ricostruttivo, Dipartimento Chirurgia Generale e Specialistiche, Arcispedale S. Maria Nuova, IRCCS, Viale Umberto I, 50, 42123 Reggio Emilia, Italy. Electronic address: carolina.castroruiz85@gmail.com.
authors.forename: Carolina
authors.initials: C
authors.lastname: Castro Ruiz
authors.affiliation: Chirurgia I a prevalente indirizzo Oncologico Ricostruttivo, Dipartimento Chirurgia Generale e Specialistiche, Arcispedale S. Maria Nuova, IRCCS, Viale Umberto I, 50, 42123 Reggio Emilia, Italy. Electronic address: claudio.pedrazzoli@asmn.re.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pedrazzoli
authors.affiliation: Chirurgia I a prevalente indirizzo Oncologico Ricostruttivo, Dipartimento Chirurgia Generale e Specialistiche, Arcispedale S. Maria Nuova, IRCCS, Viale Umberto I, 50, 42123 Reggio Emilia, Italy. Electronic address: stefano.bonacini@asmn.re.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonacini
keywords: Diagnosis; Gallbladder metastatic disease; Renal cell carcinoma; Treatment