title: Gallbladder neuroendocrine neoplasm: a case report and critical evaluation of WHO classification.
abstract: Gallbladder neuroendocrine neoplasms (GB-NENs) are rare. The majority of GB-NENs are poorly differentiated, with increased mitotic activity and clinically aggressive course. Surgery is the only curative approach and the optimal medical treatment is uncertain. In this report we describe the case of a woman affected by metastatic well differentiated GB-NEN with increased Ki 67. The patient underwent surgical removal of the gallbladder neoplasm and showed disease recurrence with pulmonary and liver metastases. After achieving a partial chemotherapy response, the patient rapidly died due to progressive disease. This case raises important issues. Well differentiated NENs with a high proliferative index are not included as a specific entity in any of the most widely used nomenclature systems. Moreover considering the proliferative index of the disease, it is reasonable to consider the patient a candidate for chemotherapy. Nevertheless, recently published papers raise the possibility that well differentiated NENs and specific proliferative index cutoff can predict low chemosensitivity in patients with highly proliferative neuroendocrine carcinoma.
authors.affiliation: Medical Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence 50134, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Meoni
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Antonuzzo
authors.forename: Luca
authors.initials: L
authors.lastname: Messerini
authors.forename: Elisa
authors.initials: E
authors.lastname: Giommoni
authors.forename: Andrea
authors.initials: A
authors.lastname: Muto
authors.forename: Paolo
authors.initials: P
authors.lastname: Petreni
authors.forename: Agnese
authors.initials: A
authors.lastname: Vannini
authors.forename: Alice
authors.initials: A
authors.lastname: Lunghi
authors.forename: Elena
authors.initials: E
authors.lastname: Molinara
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Costanzo
mesh_terms: D000368:Aged; D017809:Fatal Outcome; D005260:Female; D005706:Gallbladder Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D060787:Neoplasm Grading; D018358:Neuroendocrine Tumors / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery