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Biphasic large cell neuroendocrine carcinoma--pure mucinous carcinoma of the gallbladder (MANEC): a unique combination.
[carcinoma of the gallbladder]
We
report
a
case
of
primary
combined
large
cell
neuroendocrine
carcinoma
(
LCNEC
)
-
-
pure
mucinous
carcinoma
of
the
gallbladder
(
MANEC
)
-
-
which
represents
the
first
description
of
this
entity
.
The
patient
is
a
59
-
year
-old
Italian
male
who
underwent
cholecystectomy
under
a
preoperative
diagnosis
of
cholecystitis
with
gallstones
and
gallbladder
tumour
.
During
laparotomy
,
cholecystectomy
,
liver
wedge
resection
and
regional
lymph
node
dissection
were
performed
.
The
resected
gallbladder
showed
a
thickened
wall
,
gallstones
and
a
4
cm
gelatinous
,
cauliflower-like
soft
tissue
mass
.
Following
surgery
,
the
gallbladder
tumour
was
diagnosed
as
a
mixed
endocrine-exocrine
carcinoma
.
There
was
evidence
of
lymph
node
metastasis
or
direct
liver
invasion
.
The
mucin-producing
carcinoma
was
composed
of
poorly
differentiated
glandular
cells
with
mucin
lakes
.
The
LCNEC
was
characterized
by
large
cells
with
prominent
nucleoli
,
coarse
chromatin
and
a
high
mitotic
rate
.
The
cells
showed
an
"
organoid
"
growth
pattern
with
rosette
formation
and
frequent
areas
of
necrosis
.
Chromogranin
A
,
synaptophysin
and
CD
5
6
were
diffusely
and
strongly
expressed
.
This
case
may
provide
helpful
insights
regarding
the
histogenesis
of
this
unusual
combination
of
tumors
:
the
concept
of
a
collision
tumor
between
two
neoplasms
that
have
arisen
in
adjacent
areas
may
be
the
best
explanation
for
its
pathogenesis
.
Diseases
Validation
Diseases presenting
"cauliflower-like soft tissue mass"
symptom
carcinoma of the gallbladder
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