Successful resection of a neuroendocrine tumor in the gallbladder: a case report

Abstract Background Gallbladder neuroendocrine tumors (GB-NETs) are extremely rare, representing only 0.5% of all NETs because no neuroectodermal cells are present in the gallbladder. In 2019, the World Health Organization updated the classification of NETs based on their molecular differences. The...

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Main Authors: Hideo Tomihara, Kazuhiko Hashimoto, Tomoko Wakasa, Hajime Ishikawa, Tomoyuki Tsujimoto, Atsushi Gakuhara, Shuichi Fukuda, Katsuya Ohta, Kotaro Kitani, Jin-ichi Hida, Yoshio Ohta, Masao Yukawa
Format: Article
Language:English
Published: Japan Surgical Society 2020-10-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-020-01055-w
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author Hideo Tomihara
Kazuhiko Hashimoto
Tomoko Wakasa
Hajime Ishikawa
Tomoyuki Tsujimoto
Atsushi Gakuhara
Shuichi Fukuda
Katsuya Ohta
Kotaro Kitani
Jin-ichi Hida
Yoshio Ohta
Masao Yukawa
author_facet Hideo Tomihara
Kazuhiko Hashimoto
Tomoko Wakasa
Hajime Ishikawa
Tomoyuki Tsujimoto
Atsushi Gakuhara
Shuichi Fukuda
Katsuya Ohta
Kotaro Kitani
Jin-ichi Hida
Yoshio Ohta
Masao Yukawa
author_sort Hideo Tomihara
collection DOAJ
description Abstract Background Gallbladder neuroendocrine tumors (GB-NETs) are extremely rare, representing only 0.5% of all NETs because no neuroectodermal cells are present in the gallbladder. In 2019, the World Health Organization updated the classification of NETs based on their molecular differences. The mutation status of DAXX and ATRX has been added to the criteria for well-differentiated NETs. Case presentation A 50-year-old man presented to our hospital for further examination of a gallbladder polyp. He had no right quadrant pain, fever, jaundice, weight loss, or carcinoid syndrome-related symptoms. The patient hoped to avoid cholecystectomy. During the 3-year observation period, the polyp gradually increased in size from 8.3 to 9.9 mm. He decided to undergo surgery, and whole cholecystectomy was successfully performed. Immunohistochemical staining revealed positivity for chromogranin A, synaptophysin, and CD56. The Ki-67 index was < 3%. Taken together, these results led to a diagnosis of a grade 1 GB-NET. We also performed immunohistochemical staining of DAXX and ATRX, which revealed that DAXX protein expression was negative. The patient’s postoperative course was uneventful, and he developed no recurrence for 8 years after surgery. Conclusion We experienced a very rare case of GB-NET. Obtaining a correct preoperative diagnosis is quite difficult at the first evaluation. A GB-NET should be considered as a differential diagnosis of gallbladder tumors.
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spelling doaj-art-b775d0fdae8041fbbbf3b55f917aba522025-08-20T03:38:40ZengJapan Surgical SocietySurgical Case Reports2198-77932020-10-01611610.1186/s40792-020-01055-wSuccessful resection of a neuroendocrine tumor in the gallbladder: a case reportHideo Tomihara0Kazuhiko Hashimoto1Tomoko Wakasa2Hajime Ishikawa3Tomoyuki Tsujimoto4Atsushi Gakuhara5Shuichi Fukuda6Katsuya Ohta7Kotaro Kitani8Jin-ichi Hida9Yoshio Ohta10Masao Yukawa11Department of Surgery, Kindai University Nara HospitalDepartment of Surgery, Kindai University Nara HospitalDepartment of Pathology and Laboratory, Kindai University Nara HospitalDepartment of Surgery, Kindai University Nara HospitalDepartment of Surgery, Kindai University Nara HospitalDepartment of Surgery, Kindai University Nara HospitalDepartment of Surgery, Kindai University Nara HospitalDepartment of Surgery, Kindai University Nara HospitalDepartment of Surgery, Kindai University Nara HospitalDepartment of Surgery, Kindai University Nara HospitalDepartment of Pathology and Laboratory, Kindai University Nara HospitalDepartment of Surgery, Kindai University Nara HospitalAbstract Background Gallbladder neuroendocrine tumors (GB-NETs) are extremely rare, representing only 0.5% of all NETs because no neuroectodermal cells are present in the gallbladder. In 2019, the World Health Organization updated the classification of NETs based on their molecular differences. The mutation status of DAXX and ATRX has been added to the criteria for well-differentiated NETs. Case presentation A 50-year-old man presented to our hospital for further examination of a gallbladder polyp. He had no right quadrant pain, fever, jaundice, weight loss, or carcinoid syndrome-related symptoms. The patient hoped to avoid cholecystectomy. During the 3-year observation period, the polyp gradually increased in size from 8.3 to 9.9 mm. He decided to undergo surgery, and whole cholecystectomy was successfully performed. Immunohistochemical staining revealed positivity for chromogranin A, synaptophysin, and CD56. The Ki-67 index was < 3%. Taken together, these results led to a diagnosis of a grade 1 GB-NET. We also performed immunohistochemical staining of DAXX and ATRX, which revealed that DAXX protein expression was negative. The patient’s postoperative course was uneventful, and he developed no recurrence for 8 years after surgery. Conclusion We experienced a very rare case of GB-NET. Obtaining a correct preoperative diagnosis is quite difficult at the first evaluation. A GB-NET should be considered as a differential diagnosis of gallbladder tumors.http://link.springer.com/article/10.1186/s40792-020-01055-wGallbladderNeuroendocrine tumorCarcinoid
spellingShingle Hideo Tomihara
Kazuhiko Hashimoto
Tomoko Wakasa
Hajime Ishikawa
Tomoyuki Tsujimoto
Atsushi Gakuhara
Shuichi Fukuda
Katsuya Ohta
Kotaro Kitani
Jin-ichi Hida
Yoshio Ohta
Masao Yukawa
Successful resection of a neuroendocrine tumor in the gallbladder: a case report
Surgical Case Reports
Gallbladder
Neuroendocrine tumor
Carcinoid
title Successful resection of a neuroendocrine tumor in the gallbladder: a case report
title_full Successful resection of a neuroendocrine tumor in the gallbladder: a case report
title_fullStr Successful resection of a neuroendocrine tumor in the gallbladder: a case report
title_full_unstemmed Successful resection of a neuroendocrine tumor in the gallbladder: a case report
title_short Successful resection of a neuroendocrine tumor in the gallbladder: a case report
title_sort successful resection of a neuroendocrine tumor in the gallbladder a case report
topic Gallbladder
Neuroendocrine tumor
Carcinoid
url http://link.springer.com/article/10.1186/s40792-020-01055-w
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