ABSTRACT Gallbladder metastasis from renal cell carcinoma is rare, and synchronous para‐aortic lymph node metastasis has been scarcely reported. An 83‐year‐old man who had undergone laparoscopic right nephrectomy previously was found to have a polypoid gallbladder lesion and an enlarged para‐aortic lymph node. Endoscopic ultrasound‐guided fine‐needle aspiration of the lymph node revealed atypical clear cells positive for AE1/3, renal cell carcinoma marker, and PAX8. Laparoscopic full‐thickness cholecystectomy and targeted excision of the para‐aortic lymph node were performed. Histopathology confirmed metastatic clear cell renal cell carcinoma in both lesions. Recovery was uneventful, without chyle leak. He remains recurrence‐free at 6 months. This case demonstrates the technical feasibility and short‐term safety of a totally laparoscopic approach.
Kuno et al. (Thu,) studied this question.