Combined Undifferentiated and Neuroendocrine Carcinomas of the Gallbladder Appearing as Two Separate Lesions: A Case Report with Radiological-Pathological Correlation

Abstract

We report herein a rare case of incidentally detected combined undifferentiated and neuroendocrine carcinomas of the gallbladder. An incidental gallbladder malignancy was revealed on abdominal ultrasound and multi-detector computed tomography in a 54-year-old man. A short distance from the main polypoid hypoechoic mass at the fundus of the gallbladder, focal wall thickening was noted with prominently increased power Doppler flow. Extended cholecystectomy was performed, and histology confirmed the main polypoid mass as undifferentiated carcinoma and the separate nodule as neuroendocrine carcinoma. To our knowledge, this is the first report presenting two separate lesions of combined gallbladder carcinomas by radiological features.

Neuroendocrine tumor of the gall bladder: A rare case report with review of literature

“…Gall bladder is a rare site for neuroendocrine cells. The etiology of GB-NET is debatable [7] . Few hypotheses have been postulated describing its etiology.…”

Gallbladder Neuroendocrine Carcinoma: A Case Report with Radiological–Pathological Correlation

“…4 There has been no reported difference in CT findings between adenocarcinoma and neuroendocrine carcinoma. 8 NETs in other locations are typically hypervascular tumors. On contrast scans, primary NETs (gastrointestinal and lung NETs) and their metastases show hyperenhancement, and they are usually best seen in the arterial phase.…”

“…7 NET can occur alone or in combination with other types of GB cancers, such as adenocarcinoma or squamous cell carcinoma. 8 GB is a rare location for neuroendocrine cells. The cause of GB NEC is debatable.…”

“…The cause of GB NEC is debatable. 8 The first is intestinal metaplasia of the GB mucosa, which can be caused by chronic inflammatory conditions and may contain neuroendocrine cells. Second, GBNETs can develop from endodermal stem cells or progenitor cells that have the ability to differentiate in multiple directions.…”

Clinicopathological characteristics and prognostic factors of patients with primary gallbladder neuroendocrine carcinomas

“…The exclusion criteria of the studies for literature review were as follows: (a) primary lesion arising from organs other than the gallbladder; (b) histological subtype of GB‐NET was not pathologically confirmed; (c) studies on GB‐NET or well‐differentiated MiNEN; (d) review articles, meta‐analyses, editorials, commentaries, or animal studies, etc; (e) the required clinicopathological data could not be extracted; and (f) insufficient data on the follow‐up or patient outcomes. After literature search data of additional 47 patients from 38 studies were obtained 5,7,9–44 . Finally, a total of 62 patients with GB‐NEC including poorly differentiated MiNEN were finally enrolled.…”