-Case Reports-

Combined Neuroendocrine Cell Carcinoma and Adenocarcinoma of the Gallbladder: Report of a Case

Tetsuya Shimizu¹, Takashi Tajiri¹, Koho Akimaru¹, Yasuo Arima¹, Hiroshi Yoshida¹, Shigeki Yokomuro¹, Yasuhiro Mamada¹, Nobuhiko Taniai¹, Yoshiaki Mizuguchi¹, Yutaka Kawahigashi¹ and Zenya Naito²

¹Graduate School of Medicine, Surgery for Organ Function and Biology Regulation, Nippon Medical School
²Second Department of Pathology, Nippon Medical School

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 comfirmed thickening of the gallbladder wall and a 15 × 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 adenocarinoma that showed a zone of transition from the small cell neuroendcrine 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 linage. 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.

J Nippon Med Sch 2006; 73: 101-105

Keywords
neuroendocrine cell carcinoma, adenocarcinoma

Correspondence to
Tetsuya Shimizu, MD, Graduate School of Medicine, Surgery for Organ Function and Biology Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
tetsuya@nms.ac.jp

Received, December 13, 2005
Accepted, March 6, 2006