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A large cell neuroendocrine carcinoma of the gall bladder: diagnosis with 18FDG-PET/CT-guided biliary cytology and treatment with combined chemotherapy achieved a long-term stable condition.
[carcinoma of the gallbladder]
Poorly
differentiated
neuroendocrine
cell
carcinomas
of
the
gallbladder
are
rare
and
patients
with
such
tumors
have
a
poor
prognosis
.
We
describe
a
64
-
year
-old
male
with
a
large
cell
neuroendocrine
carcinoma
of
the
gallbladder
and
multiple
lymph
node
metastases
.
Diagnostic
excisional
biopsy
of
the
left
axillary
lymph
nodes
revealed
atypical
cells
with
predominantly
large
-sized
round
-
to
-oval
nuclei
,
proliferating
in
a
solid
and
focal
nesting
pattern
.
The
tumor
cells
were
positive
for
synaptophysin
and
chromogranin
A
,
and
strongly
positive
for
Ki-
67
,
leading
to
a
diagnosis
of
poorly
differentiated
neuroendocrine
cell
carcinoma
of
the
gallbladder
,
of
large
cell
type
.
Using
(
18
)
F-
fluorodeoxy
glucose-positron
emission
tomography
/
computed
tomography
to
determine
the
origin
of
these
tumors
,
we
observed
the
accumulation
of
(
18
)
F-
fluorodeoxy
glucose
in
multiple
large
lymph
nodes
,
a
small
part
of
the
liver
and
the
fundus
of
the
gallbladder
.
Computed
tomography-guided
aspiration
of
the
gallbladder
showed
the
same
pleomorphic
tumor
cells
as
the
lymph
nodes
.
The
patient
was
diagnosed
with
a
large
cell
neuroendocrine
carcinoma
of
the
gallbladder
,
only
∼
25
mm
in
diameter
.
Combination
chemotherapy
with
cisplatin
and
docetaxel
,
the
regimen
used
for
non-
small
cell
lung
carcinomas
,
and
probably
large
cell
lung
carcinomas
,
resulted
in
the
disappearance
of
the
lymph
node
metastases
and
a
marked
improvement
in
the
performance
status
for
∼
22
months
.
The
poor
prognosis
of
patients
with
these
aggressive
tumors
may
be
improved
by
the
use
of
minimally
invasive
diagnostic
procedures
and
combined
systemic
chemotherapy
as
soon
as
possible
.
Diseases
Validation
Diseases presenting
"a small part of the liver and the fundus of the gallbladder"
symptom
carcinoma of the gallbladder
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