Large Cell Neuroendocrine Carcinoma of the Gallbladder: A Case Report and Literature Review

Miyamoto, Ryoichi; Kikuchi, Kazunori; Uchida, Atsushi; Ozawa, Masayoshi; Nagai, K.; Maeda, Michihiro; Kemmochi, Akira; Inagawa, Satoshi; Yamamoto, Masayoshi

doi:10.9738/intsurg-d-16-00122.1

Cited by 3 publications

(3 citation statements)

References 22 publications

(49 reference statements)

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“…However, Kim et al conclude that the well-defined margin associated to larger hepatic and lymph nodes metastases are useful CT-scan differentiators of GBNECs from adenocarcinoma [ 10 ]. In all cases, the histopathology confirms the unsuspected diagnosis of GBNEC [ 8 , 9 ]. In our case, the diagnosis of a gallbladder tumor was made during the periodic follow-up of a cured right breast cancer in an asymptomatic woman.…”

Section: Discussionmentioning

confidence: 71%

“…Symptoms described by patients with GBNEC are non-specific, often related to bile duct tension such as biliary colic or acute cholecystitis or jaundice in rare cases [ 8 ]. Mostly, this disease is discovered after performing cholecystectomy for cholecystitis or cholelithiasis, in some cases, the tumor is detected on imaging leading to biopsy or surgical resection [ 6 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Pure large cell neuroendocrine carcinoma of the gallbladder, is surgical relentlessness beneficial? A case report and literature review

et al. 2021

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Pure large cell neuroendocrine carcinoma of the gallbladder is a rare disease. However, the prognosis of this aggressive tumor is poor with short survival after diagnosis. We are describing in this manuscript a case of pure large cell neuroendocrine carcinoma in which survival exceeded 26 months, after performing two curative surgeries. We are reporting the case of a 68-year-old woman with a history of recovered right breast carcinoma and operated 6 years later for a completely asymptomatic gallbladder tumor of 31 mm. In this case, curative surgery was performed allowing monobloc resection of the gallbladder and the hepatic segments IVb and V, a lymph node dissection was performed to. The histological examination of the specimen and immunohistochemistry confirms that the tumor was a grade 3 pure large cell neuroendocrine carcinoma of gallbladder with lymph node invasion, the hepatic and biliary surgical margins were free. Postoperative adjuvant chemotherapy was administered and the evolution was eventless until the discovery at 20 months of a lymph node considered being metastatic recurrence. A second surgery was performed allowing removal of three lymph nodes. This time, a different protocol of chemotherapy was administered to our patient who remains alive and without recurrence at 26 months from her first surgery. Surgical relentlessness with free margins resections associated with appropriate chemotherapy probably improves the survival of patients suffering from this rare and aggressive tumor.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Pure large cell neuroendocrine carcinoma of the gallbladder, is surgical relentlessness beneficial? A case report and literature review

et al. 2021

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“…Gallbladder neuroendocrine neoplasms (NENs) account for 0.5% of all NENs and 2.1% of gallbladder cancers. [1][2][3] Of the different types of gallbladder NENs, large cell neuroendocrine carcinoma (LCNEC) is an aggressive and exceptionally rare tumor, with about 20 cases of both pure and mixed types reported since 2000. 1,[4][5][6][7] Primary mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) of the gallbladder is even more rare.…”

Section: Introductionmentioning

confidence: 99%

Targeted Sequencing of Mixed Neuroendocrine- Non-neuroendocrine Neoplasm of the Gallbladder Suggests a Monoclonal Origin: A Case Report

Ines

Anceno

Salamat

et al. 2019

PJP

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Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) of the gallbladder is a rare tumor that is defined in the World Health Organization (WHO) 2019 digestive system tumor classification as the presence of a neuroendocrine neoplasm admixed with a non-neuroendocrine carcinoma, each component constituting at least 30% of the neoplasm. The exact pathogenesis of MiNENs remains unclear. We present a case of a 74-year-old Filipino woman who presented with nonspecific clinical and radiologic findings and subsequently underwent cholecystectomy. Histopathologic and immunohistochemical evaluation of the gallbladder confirmed the diagnosis of a mixed well-differentiated adenocarcinoma (30%) and large cell neuroendocrine carcinoma (70%). The adenocarcinoma and neuroendocrine carcinoma components were separately microdissected and submitted for targeted 15-gene sequencing using the Illumina Trusight Tumor 15 (TST15) panel. NGS identified a TP53 missense mutation leading to a stop codon in both components. The finding of similar molecular signatures in the two morphologically distinct components supports the hypothesis that MiNEN arises from a common precursor stem cell capable of divergent phenotypic differentiation.

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Primary neuroendocrine tumors of the gall bladder: Morphology with corroborative immunohistochemistry is the key to diagnosis

Bargotya¹,

Mehta²,

Sachan³

2020

JDPO

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Neoplasms with neuroendocrine differentiation comprising both neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs) arising in gall bladder are extremely rare. NETs of the gall bladder represent only 0.2% of all NETs, whereas NECs comprise of 4% cases of all the malignant neoplasms of the gall bladder. NEC is the most aggressive variant of all gall bladder carcinomas. In most of the cases diagnosis is incidental and patient usually presents at advanced stage as there are no specific clinical or radiological features to detect NECs pre-operatively. Histopathology of the resected specimen and immunochemical analysis remain the main stay of diagnosing these malignancies. This case report includes 3 cases of NECs gall bladder comprising of two cases of small cell NECs and one case of large cell NEC. Although surgery followed by chemotherapy play important role in improving the quality of life of the patients, the prognosis of this combative disease can be upgraded by understanding the biological behavior of these tumours to adapt a definitive treatment protocol. The main aim of this study is to highlight on the need for better assessment, detection and management of this rare and aggressive entity to improve the survival rate of the patients of NECs.

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Large Cell Neuroendocrine Carcinoma of the Gallbladder: A Case Report and Literature Review

Cited by 3 publications

References 22 publications

Pure large cell neuroendocrine carcinoma of the gallbladder, is surgical relentlessness beneficial? A case report and literature review

Pure large cell neuroendocrine carcinoma of the gallbladder, is surgical relentlessness beneficial? A case report and literature review

Targeted Sequencing of Mixed Neuroendocrine- Non-neuroendocrine Neoplasm of the Gallbladder Suggests a Monoclonal Origin: A Case Report

Primary neuroendocrine tumors of the gall bladder: Morphology with corroborative immunohistochemistry is the key to diagnosis

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