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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2017.08.20    [Epub ahead of print]
Combined Adenosquamous and Large Cell Neuroendocrine Carcinoma of the Gallbladder
Jiyoon Jung1, Yang-Seok Chae1, Chul Hwan Kim1, Youngseok Lee1, Jeong Hyeon Lee1, Dong-Sik Kim2, Young-Dong Yu2, Joo Young Kim1
1Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
2Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
Corresponding Author: Joo Young Kim ,Tel: +82-2-920-6268, Fax: +82-2-920-6576, Email: lepetit80@hanmail.net
Received: June 29, 2017;  Revised: August 1, 2017  Accepted: August 20, 2017.  Published online: October 5, 2017.
ABSTRACT
Large cell neuroendocrine carcinoma (LCNEC) of the gallbladder is extremely rare and usually combined with other type of malignancy, mostly adenocarcinoma. We report an unusual case of combined adenosquamous carcinoma and LCNEC of the gallbladder in a 54-year-old woman. A radical cholecystectomy specimen revealed a 4.3×4.0 cm polypoid mass in the fundus with infiltration of adjacent liver parenchyma. Microscopically, the tumor consisted of two distinct components. Adenosquamous carcinoma was predominant and abrupt transition from adenocarcinoma to squamous cell carcinoma was observed. LCNEC showed round cells with large, vesicular nuclei, abundant mitotic figures, and occasional pseudorosette formation. The patient received adjuvant chemotherapy. However, multiple liver metastases were identified at three-month follow-up. Metastatic nodules were composed of LCNEC and squamous cell carcinoma components. Detecting LCNEC component is important in gallbladder cancer, because the tumor may require a different chemotherapy regimen and show early metastasis and poor prognosis.
Key Words: Carcinoma, adenosquamous; Large cell neuroendocrine carcinoma; Gallbladder; Prognosis