Laparoscopic Full-Thickness Cholecystectomy and Para-Aortic Lymph Node Excision for Metachronous Metastases From...

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.