Case report: A challenging case of stage IVB mixed neuroendocrine-non-neuroendocrine neoplasm of the gallbladder treated with extended radical resection including portal vein reconstruction - Report - MDSpire
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Case report: A challenging case of stage IVB mixed neuroendocrine-non-neuroendocrine neoplasm of the gallbladder treated with extended radical resection including portal vein reconstruction
Clinical Report: A Complex Instance of Stage IVB Mixed Neoplasm of the Gallbladder
Overview
This report details a rare case of a 78-year-old female with a mixed neuroendocrine-non-neuroendocrine neoplasm of the gallbladder, successfully managed through extensive radical resection. The case highlights the importance of multidisciplinary collaboration in diagnosing and treating such aggressive tumors.
Background
Gallbladder cancer is a highly lethal malignancy, often diagnosed at advanced stages due to non-specific symptoms. Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN), particularly those with large cell neuroendocrine carcinoma components, are extremely rare and aggressive. Understanding the clinical characteristics and treatment strategies for these tumors is crucial for improving patient outcomes.
Data Highlights
The patient had a carcinoembryonic antigen (CEA) level of 84.09 ng/ml and underwent extensive radical surgery, including partial hepatectomy and portal vein reconstruction. Postoperative pathology confirmed a mixed adenoma-large cell neuroendocrine carcinoma with negative surgical margins.
Key Findings
The patient was diagnosed with a gallbladder mass during a routine examination.
Imaging revealed malignancy with liver and lymph node metastases.
Postoperative pathology confirmed a mixed adenoma-large cell neuroendocrine carcinoma.
Immunohistochemistry showed high Ki-67 proliferation index (approximately 80%).
All surgical margins were negative post-resection.
Clinical Implications
This case underscores the potential for aggressive surgical intervention in selected patients with advanced gallbladder cancer. The findings contribute to the limited literature on MiNEN, emphasizing the need for careful diagnosis and treatment planning.
Conclusion
The successful management of this rare case through extensive surgical resection highlights the importance of multidisciplinary approaches in treating complex gallbladder neoplasms. Further validation of oncological benefits is necessary.
