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A case of mixed adenoneuroendocrine carcinoma of the gallbladder arising from an intracystic papillary neoplasm associated with pancreaticobiliary maljunction.
[carcinoma of the gallbladder]
A
54
-
year
-old
Japanese
woman
was
referred
with
a
gallbladder
tumor
.
Based
on
the
results
of
the
computed
tomography
scan
,
endoscopic
retrograde
cholangiopancreatography
,
and
magnetic
resonance
cholangiopancreatography
,
a
mucin-producing
neoplasm
of
the
gallbladder
associated
with
pancreaticobiliary
maljunction
was
diagnosed
.
Extended
cholecystectomy
,
extrahepatic
bile
duct
resection
,
and
choledochojejunostomy
were
performed
,
and
she
remains
free
of
recurrence
24
months
after
resection
.
Histopathological
examination
revealed
that
the
papillary
component
of
the
lesion
was
an
intracystic
papillary
neoplasm
with
diverse
characteristics
of
pancreaticobiliary
epithelium
and
intestinal
epithelium
including
mucin
.
In
this
component
,
most
of
the
papillary
lesion
was
a
high
-grade
intraepithelial
neoplasm
,
but
also
showed
slight
invasion
into
the
muscular
layer
.
The
nodular
component
consisted
of
both
poorly
differentiated
biliary
type
adenocarcinoma
and
large
cell
neuroendocrine
carcinoma
.
We
report
a
rare
case
of
a
mixed
adenoneuroendocrine
carcinoma
arising
from
an
intracystic
papillary
neoplasm
associated
with
pancreaticobiliary
maljunction
.
As
for
the
histogenesis
of
this
tumor
,
based
on
the
histopathologic
appearance
,
transdifferentiation
from
poorly
differentiated
biliary
type
adenocarcinoma
to
large
cell
neuroendocrine
carcinoma
is
considered
the
most
possible
histogenesis
of
this
tumor
.
Diseases
Validation
Diseases presenting
"papillary component of the lesion"
symptom
carcinoma of the gallbladder
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