Surgical resection for hepatocellular carcinoma with metastasis to the gallbladder: Report of a case

Abstract

A metastatic tumor of the gallbladder is rare. There have so far been no detailed reports of a resection of the metastasis of hepatocellular carcinoma (HCC) to the gallbladder published in the English literature. This report presents the case of a surgical resection for hepatocellular carcinoma with metastasis to the gallbladder. A 48-year-old woman consulted her primary care physician due to chest discomfort. Tumors in the liver and gallbladder were unexpectedly found and she was thus referred to this hospital. The radiologic studies showed two tumors. A round-shaped tumor, 30 mm in diameter, in the fossa of the gallbladder of the liver protruded into the lumen of the gallbladder, and a lobulated shaped tumor, measuring 13 mm, was in S5 of the liver. Angiography demonstrated that these tumors showed a pattern of early enhancement and washout. An en bloc resection of the gallbladder and the liver surrounding the gallbladder was performed, and the final diagnosis was moderately differentiated HCC in segment S5 with gallbladder metastasis. The patient is currently doing well 2 years after surgery, without any signs of recurrence. This case demonstrated that good clinical outcome could be achieved by performing surgery in HCC patients with metastasis to the gallbladder.

Gallbladder metastasis from hepatocellular carcinoma: Report of a case and review of literature

“…The resected cases of metastatic HCC to the gallbladder are shown in Tables 1 and 2. [8][9][10][11][12][13][14][15] A preoperative diagnosis of metastatic HCC to the gallbladder is difficult. Two patients required cholecystectomy due to cholecystitis.…”

“…19 The survival rate, in all reported cases including the present case, was increased in patients who underwent radical resection, compared to patients who underwent palliative surgery, which suggests that radical resection might be the more useful method for curability. 15 Although strong evidence is lacking to support an aggressive approach to resection, it seems reasonable to perform radical resections for patients with potentially curable disease and to produce a satisfactory local response. More experience and long-term follow-up is necessary to justify the risks of surgical resection.…”

A case of resected hepatocellular carcinoma with gallbladder metastasis

“…There are only five reported patients, including our patient, who survived over 2 years after surgical resection for gallbladder metastasis from HCC (Table 1) [8,11,12]. No characteristic profiles other than curative resection were found to achieve long-term survival.…”

Invasion Patterns and Metastatic Patterns of Hepatocellular Carcinoma

“…HCC, mainly right-sided tumors, can invade or metastasize into this organ (Murakami et al 2008;Ryu et al 2009;Kanzaki et al 2011;Terada and Maruo 2013). Invading tumors macroscopically form a nodule that originates in the liver substance close to the gallbladder fossa and which extends into the gallbladder wall, with effacement of the wall structures.…”