What is it about?
Ultrasound images of gallbladder metastasis from renal cell carcinoma (GBMRCC) are described. They are different from those of advanced gallbladder carcinoma (GBC). However, the differential diagnosis of GBMRCC from early GBC is crucial. as they are similar to those of early GBC. The title of White et al.’s article, “Unexpected Gallbladder Metastasis of Clear Cell Renal Carcinoma” is not appropriate since a large pedunculated gallbladder polyp, such as one measuring 2 cm in diameter, generally suggests malignancy. Additionally, ultrasound criteria for T1 or T2 GBC are documented. A protruded lesion without or with a deep hypoechoic area, accompanied by a conically thickened outermost hyperechoic layer corresponds to T1b or shallow T2 carcinoma (subserosal invasion depth ≤ 2 mm), respectively. A deep hypoechoic area represents an adenocarcinoma invading subserosa, accompanied by abundant fibrosis and lymphocytic infiltration, regardless of the characteristics of the outermost hyperechoic layer. Furthermore, the presence of a deep hypoechoic area is more significant than a thinned nor a split outermost hyperechoic layer in diagnosing the depth of carcinoma invasion.
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Why is it important?
Patients with GBMRCC have a good postoperative prognosis like early (T1) GBC.
Perspectives
Diagnosing GBMRCC on ultrasound is crucial.
Ph.D., M.D. Taketoshi Fujimoto
Iida Hospital
Read the Original
This page is a summary of: Letter to the Editor: How Is Gallbladder Metastasis From Renal Cell Carcinoma Depicted on Ultrasound?, Clinical Pathology, January 2023, SAGE Publications,
DOI: 10.1177/2632010x231218074.
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