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Large cell neuroendocrine carcinoma of the gallbladder: long survival achieved by multimodal treatment.
[carcinoma of the gallbladder]
Large
cell
neuroendocrine
carcinoma
of
the
gall-
bladder
is
a
rare
disease
in
which
the
prognosis
worsens
with
size
.
We
report
a
case
of
large
cell
neuroendocrine
carcinoma
of
the
gallbladder
in
a
64
-
year
-old
woman
who
presented
with
a
right
upper
quadrant
mass
whose
longest
diameter
was
11
.
5
cm
;
the
mass
was
initially
considered
to
be
unresectable
because
of
probable
invasion
to
the
main
portal
vein
and
biliary
tract
.
The
patient
received
multi-modal
treatment
,
consisting
of
intraarterial
chemotherapy
,
three
-dimensional
radiation
therapy
,
right
trisegmentectomy
,
and
gamma-knife
irradiation
(
for
brain
metastases
)
.
She
has
survived
for
69
months
since
the
initial
diagnosis
and
has
shown
no
signs
of
recurrence
at
35
months
after
the
last
gamma-knife
irradiation
for
brain
metastases
.
This
result
suggests
that
multimodal
treatment
including
surgery
,
chemotherapy
,
and
radiation
therapy
achieved
a
good
response
and
led
to
long
survival
.