title: Large cell neuroendocrine carcinoma of the gallbladder: long survival achieved by multimodal treatment.
abstract: Large cell neuroendocrine carcinoma of the gall-bladder is a rare disease in which the prognosis worsens with size. We report a case of large cell neuroendocrine carcinoma of the gallbladder in a 64-year-old woman who presented with a right upper quadrant mass whose longest diameter was 11.5 cm; the mass was initially considered to be unresectable because of probable invasion to the main portal vein and biliary tract. The patient received multi-modal treatment, consisting of intraarterial chemotherapy, three-dimensional radiation therapy, right trisegmentectomy, and gamma-knife irradiation (for brain metastases). She has survived for 69 months since the initial diagnosis and has shown no signs of recurrence at 35 months after the last gamma-knife irradiation for brain metastases. This result suggests that multimodal treatment including surgery, chemotherapy, and radiation therapy achieved a good response and led to long survival.
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Japan.
authors.forename: Chigusa
authors.initials: C
authors.lastname: Shimono
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suwa
authors.forename: Morio
authors.initials: M
authors.lastname: Sato
authors.forename: Shintaro
authors.initials: S
authors.lastname: Shirai
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Yamada
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy*; D018287:Carcinoma, Large Cell / Q000556:secondary / Q000628:therapy*; D018278:Carcinoma, Neuroendocrine / Q000556:secondary / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011829:Radiation Dosage; D016634:Radiosurgery; D018714:Radiotherapy, Adjuvant; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
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