title: [Neuroendocrine small-cell carcinoma of the gallbladder. An unexpected finding after diagnostic laparoscopy].
abstract: BACKGROUND
  Gallbladder cancer ranks fifth among oncological diseases affecting the gastrointestinal tract; nevertheless, it is the world's most common malignant tumor of the bile ducts. It is usually diagnosed after cholecystectomy and tends to have bad prognosis. Adenocarcinoma is the main histological finding, although other rare histologic types have been described among the actual literature. Poorly differentiated squamous-cell neuroendocrine gallbladder carcinoma is an extremely rare neoplasm. A poor prognosis is associated with this histological type.
  
  
  OBJECTIVE
  The aim of this paper is to show that performing a systematic exploration of the entire peritoneal cavity in all laparoscopic surgeries can lead to find completely unexpected changes related to an unidentified disease. Also, a detailed review of our unexpected finding is made: The neuroendocrine small cell carcinoma of gallbladder.
  
  
  METHODS
  We hereby report the case of a 40-year-old patient with a ruptured ectopic pregnancy that underwent emergency laparoscopic surgery, presenting the incidental finding of a small-cell carcinoma of the gallbladder.
  
  
  CONCLUSIONS
  Our surgical group advised that by introducing the laparoscope, the entire peritoneal cavity must be systematically reviewed, in search of differential diagnoses and unidentified pathologies. We must use the diagnostic and therapeutic qualities of laparoscopy. Bile duct endocrine tumors tend to remain silent until advanced stages, making the prognosis usually unfavorable, especially when they are unresectable. Endocrine neoplasias of the gallbladder, although uncommon, should be taken into account as possible diagnoses due to its therapeutic and prognostic implications.
authors.affiliation: Departamento de Cirugía General, Fundación Clínica Médica Sur, Ciudad de México, México; Facultad Mexicana de Medicina, Universidad La Salle, Ciudad de México, México. Electronic address: Medicina00@gmail.com.
authors.forename: Mario Andrés
authors.initials: MA
authors.lastname: González-Chávez
authors.affiliation: Departamento de Cirugía General, Fundación Clínica Médica Sur, Ciudad de México, México; Facultad Mexicana de Medicina, Universidad La Salle, Ciudad de México, México.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Villegas-Tovar
authors.affiliation: Facultad de Ciencias de la Salud, Universidad Panamericana, Ciudad de México, México.
authors.forename: Daniel
authors.initials: D
authors.lastname: González Hermosillo-Cornejo
authors.affiliation: Departamento de Cirugía General, Fundación Clínica Médica Sur, Ciudad de México, México; Facultad Mexicana de Medicina, Universidad La Salle, Ciudad de México, México.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Gutierrez-Ocampo
authors.affiliation: Departamento de Ginecología y Obstetricia, Fundación Clínica Médica Sur, Ciudad de México, México.
authors.forename: José Alfredo
authors.initials: JA
authors.lastname: López-Rangel
authors.affiliation: Departamento de Cirugía General, Fundación Clínica Médica Sur, Ciudad de México, México; Facultad Mexicana de Medicina, Universidad La Salle, Ciudad de México, México.
authors.forename: Amado de Jesús
authors.initials: AJ
authors.lastname: Athié-Athié
mesh_terms: D000328:Adult; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis*; D018288:Carcinoma, Small Cell / Q000175:diagnosis*; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis*; D006801:Humans; D033162:Incidental Findings; D010535:Laparoscopy
keywords: Carcinoma; Gall bladder; Laparoscopia; Laparoscopy; Neoplasia; Neoplasms; Vesícula biliar