PMC3199123_01
(a) Primary renal cell carcinoma (clear cell type) in the kidney. The tumor (t) is sharply demarcated from the renal parenchyma (k). The tumor consists of sheets of large epithelial cells with an optically empty cytoplasm and sharp cell borders (inset). (original magnification 25x and 200x (inset); Hematoxylin Eosin stain), (b) Metastasis of clear cell carcinoma in the oscalcaneum. Note the similar cell type in metastasis and primary tumor (original magnification 200x; Hematoxylin Eosin stain). (c) Ovarian metastasis of clear cell carcinoma. Note the similar cell type in metastasis and primary tumor (original magnification 200x; Hematoxylin Eosin stain). (d) Metastasis of clear cell carcinoma in the gallbladder. The tumor (t) is located deep in the cholecystic wall (m: mucosa) (original magnification 25x; Hematoxylin Eosin stain). Inset: the tumor cells show the typical membranous staining pattern for CD10, consistent with the immunophenotype of a clear cell RCC (original magnification 200x; immunohistochemical CD10 stain).
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fig1
After wedge excision, histopathology identified the lesion as a metastasis originating from an RCC (Figure 1). Vascular invasion, but no capsular extension, was observed (Figure 1). Pathologic analysis showed a uterine myoma, a negative right iliac lymph node, and a clear cell tumor in the left ovary compatible with an RCC metastasis (Figure 1).  Macroscopic and microscopic appearances led to the diagnosis of an RCC metastasis (Figure 1).
Contrast-enhanced CT of the pelvis showing a large myoma on the right side of the uterus. Note the cyst-like lesion in the left ovarium, without intraluminal nodules (arrow).
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fig2
Tomography revealed multiple adenopathies and a fibromyomatous uterus (Figure 2).
CT scan showing status after right nephrectomy and an evolutive papillary lesion in the gallbladder of approximately 1.9 cm ((a) and (b), arrows). (b) Contains the coronal reconstruction.
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fig3
August 2008, an abdominal CT scan identified a polypoid lesion in the gallbladder (Figure 3). A laparoscopic cholecystectomy was performed.