Mixed adenoneuroendocrine carcinoma of the gallbladder, histopathological features

Azad, Shweta; Shukla, Deepti; Garg, Ankur; Negi, Sanjay Singh; Malhotra, Veena

doi:10.4103/0377-4929.168879

Cited by 10 publications

(5 citation statements)

References 1 publication

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“…Included studies. A total of 15 studies (14 case reports and 1 case series), which comprised 19 patients who successfully underwent surgical treatment for gMANEC were considered eligible for inclusion and analysis in our systematic review as shown in Table I (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”

Section: Resultsmentioning

confidence: 99%

Mixed Adenoneuroendocrine Carcinoma (MANEC) of the Gallbladder: A Systematic Review of Outcomes Following Surgical Management

Machairas

Πασπάλα

Frountzas

et al. 2019

In Vivo

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Background/Aim: Mixed adenoneuroendocrine carcinomas (MANEC) are uncommon tumors exhibiting both adenocarcinomatous and neuroendocrine differentiation. They most commonly arise in the colon, appendix, rectum or stomach, however, a limited number of MANECs have been reported to originate in the gallbladder (gMANEC). The aim of our systematic review was to accumulate the existing data on gMANEC with special attention to the clinicopathological characteristics, surgical approach, recurrence and survival rates of patients diagnosed with this rare malignancy. Materials and Methods: A comprehensive search of the literature was undertaken. Results: A total of 15 studies (14 case reports and 1 case series), which comprised 19 patients who successfully underwent surgical treatment for gMANEC were included in our systematic review. During a median follow-up of 8 months (range=2-48 months) the overall survival was 87% and the recurrence rate was 21%. Conclusion: Achievement of complete surgical resection is the mainstay of the therapeutic management. Additionally, the stage of the disease and the histopathological mapping of these tumors affect decision-making for adjuvant chemotherapy and seem to define the prognostic course of each patient.

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Section: Resultsmentioning

confidence: 99%

Mixed Adenoneuroendocrine Carcinoma (MANEC) of the Gallbladder: A Systematic Review of Outcomes Following Surgical Management

Machairas

Πασπάλα

Frountzas

et al. 2019

In Vivo

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“…A peculiar histomorphological finding in our case was the presence of an insular pattern of growth with peripheral palisading and salt-and-pepper nuclei. This component constituted almost half of the tumor, which was morphologically suggestive of mixed adenoneuroendocrine carcinoma [19]. Interestingly, these foci were negative for synaptophysin, chromogranin, NSE and CD56, while they were positive for cytokeratin, so mixed adenoneuroendocrine carcinoma was excluded.…”

Section: Discussionmentioning

confidence: 99%

Poorly Cohesive Cell Carcinoma of the Gallbladder with Signet Rings and Neuroendocrine-Like Morphology: A Rare Incidental Histopathological Diagnosis with Lessons to Learn

Khader

Nsour²,

Alrubaye³

et al. 2019

Am J Case Rep

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Patient: Male, 46Final Diagnosis: Poorly cohesive cell carcinoma of the gallbladderSymptoms: Abdominal painMedication: —Clinical Procedure: Surgery and chemotherapySpecialty: PathologyObjective:Rare diseaseBackground:Poorly cohesive cell carcinoma of the gallbladder is extremely rare.Case Report:Here we present a case of a 46-year-old male with the clinical diagnosis of acute cholecystitis. The ultrasound showed gallbladder wall thickening and multiple stones. Cholecystectomy was performed, and the gross examination revealed linitis plastica-like thickening of the gallbladder wall. The microscopic examination revealed diffuse infiltration by a poorly differentiated tumor with signet rings. Another component with insular growth pattern and salt-and-pepper nuclei was present. Immunohistochemical findings were consistent with poorly cohesive cell carcinoma of the gallbladder. Imaging studies revealed regional lymph nodes involvement, in addition to peritoneal and liver metastases. The patient was given chemotherapy, and there was no evidence of disease progression at 4 months post-operation.Conclusions:This case supported that all cholecystectomy specimens must be examined. In addition, although poorly cohesive cell carcinoma was reported to be aggressive, the present case showed a protracted clinical course; this pointed to the need for early clinicoradiological suspicion. This is the first case of poorly cohesive cell carcinoma of the gallbladder with a neuroendocrine-like morphology that mimics mixed adenoneuroendocrine carcinoma. Immunohistochemistry is invaluable in such a scenario.

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“…Other initial reports showed that biliary tract NETs are only 0.2–2.0% of bile duct neoplasm [9] , [10] , with reports of MANECs of the bile duct being scarce. There were reports of some bile duct MANECs since 2010, with their origins subdivided into the gallbladder [3] , [4] , [6] , [11] , [12] . This study is the first reported case of cystic duct MANEC.…”

Section: Discussionmentioning

confidence: 99%

“…Neuroendocrine tumors (NETs) commonly occur in the gastrointestinal tract, pancreas, and lung, but bile duct origin of NETs is uncommon [2] . Some cases of MANEC derived from the bile duct have been reported [3] , [4] , [5] , [6] . Although NECs of the bile duct are frequently associated with liver or lymph node metastases in the preoperative state, aggressive radical operative therapy and adjuvant chemotherapy contributes to long-term outcomes [7] .…”

Section: Introductionmentioning

confidence: 99%

Mixed adenoneuroendocrine carcinoma derived from the cystic duct: A case report

Takemoto

Abe

Amano

et al. 2017

International Journal of Surgery Case Reports

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HighlightsWe report here an extremely rare case of mixed adenoneuroendocrine carcinomas (MANECs) derived from cystic duct. Histologically, the tumor had components of both well-differentiated tubular adenocarcinoma and neuroendocrine carcinoma with massive venous invasion.R0 resection was established, but the risk of recurrence in liver was estimated to be significantly high, due to the detected venous invasion of the neuroendocrine carcinoma in the resection margin of the hepatic duct. Eight months after surgery, multiple liver metastases were discovered, and treatment with adjuvant chemotherapy was initiated.Though standards of diagnosis and treatment for MANECs of the bile duct have not been established, multidisciplinary therapy is necessary to improve outcomes.

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Mixed adenoneuroendocrine carcinoma of the gallbladder, histopathological features

Abstract: An unusual case of mixed adenoneuroendocrine carcinoma is described which posed a diagnostic challenge in view of neuroendocrine component mimicking signet ring cells of adenocarcinoma. Diagnostic criteria for these mixed tumors, their histogenesis and treatment modalities are highlighted.

Cited by 10 publications

References 1 publication

Mixed Adenoneuroendocrine Carcinoma (MANEC) of the Gallbladder: A Systematic Review of Outcomes Following Surgical Management

Mixed Adenoneuroendocrine Carcinoma (MANEC) of the Gallbladder: A Systematic Review of Outcomes Following Surgical Management

Poorly Cohesive Cell Carcinoma of the Gallbladder with Signet Rings and Neuroendocrine-Like Morphology: A Rare Incidental Histopathological Diagnosis with Lessons to Learn

Mixed adenoneuroendocrine carcinoma derived from the cystic duct: A case report

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