Porcelain gall bladder in a case of papillary renal cell carcinoma: A rare occurrence and its impact on treatment verdict

Multiple primary malignant neoplasms (MPMN) is a rare clinical entity in which two primary malignancies are encountered in the same individual which can be synchronous (second primary within 6 months) or metachronous (beyond 6 months). We present a case of a 41-year-old male who underwent left partial nephrectomy for suspected renal cell carcinoma and it was confirmed based on histopathology. The gallbladder was normal on contrast-enhanced computed tomogram (CECT) abdomen. Follow-up CECT done 1 year later showed no enhancing masses in both kidneys, but incidentally porcelain gallbladder was detected. An elective open cholecystectomy was done for acalculous porcelain gall bladder owing to its premalignant nature. We report this case to highlight the relative risk of second primaries in patients treated for primary malignancies and that relevant premalignant conditions should be managed as possible second malignancies to avoid potential complications.