title: Combined neuroendocrine cell carcinoma and adenocarcinoma of the gallbladder: report of a case.
abstract: A 58-year-old man with a chief complaint of epigastralgia was admitted to our hospital. Physical examination disclosed a large, firm mass in the right hypochondrium. Abdominal computed tomography confirmed thickening of the gallbladder wall and a 15 x 8 cm mass occupying almost all of the right lobe and medial segment of the liver. With a preoperative diagnosis of malignant gallbladder tumor infiltrating the liver, right hepatic trisegmentectomy was performed. Histopathologic examination showed atypical cells with small round to oval nuclei and sparse eosinophilic cytoplasm, proliferating in a solid and focal nesting pattern. Near this small cell proliferation was a focus of tubular adenocarcinoma that showed a zone of transition from the small cell neuroendocrine pattern. The small cells demonstrated immunohistochemical reactivity for chromogranin A. Electron microscopy disclosed neurosecretory granules 150 nm in diameter, representing dense round core vesicles, confirming a neuroendocrine cell lineage. The patient was diagnosed with neuroendocrine cell carcinoma combined with adenocarcinoma of the gallbladder. Tumor recurrence became evident 3 months after surgery, and he died 4 months after surgery.
authors.affiliation: Graduate School of Medicine, Surgery for Organ Function and Biology Regulation, Nippon Medical School, Sendagi, Tokyo, Japan. tetsuya@nms.ac.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shimizu
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
authors.forename: Koho
authors.initials: K
authors.lastname: Akimaru
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Arima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yokomuro
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mamada
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kawahigashi
authors.forename: Zenya
authors.initials: Z
authors.lastname: Naito
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D018278:Carcinoma, Neuroendocrine / Q000473:pathology*; D005706:Gallbladder Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology*