Sumiya Ryusuke, Shimizu Atsushi, Nagai Takeshi, Ono Hayato, Kumazawa Keigo, Endo Daisuke, Oide Takashi, Aoyanagi Nobuyoshi
Department of Surgery, Kohnodai Hospital, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa-shi, Chiba, 272-8156, Japan.
Department of Pathology and Laboratory Medicine, Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan.
World J Surg Oncol. 2021 Jan 2;19(1):3. doi: 10.1186/s12957-020-02104-2.
Gallbladder neuroendocrine neoplasm is a rare disease that is divided into neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). Clear cell NETs of the gallbladder are extremely rare. We report the case of a patient with polypoid clear cell NET G1 of the gallbladder who underwent laparoscopic cholecystectomy.
A 10-mm pedunculated polyp in the gallbladder neck was detected on a follow-up abdominal ultrasound in a 60-year-old man with chronic hepatitis and hepatitis B without medication. Six months later, an abdominal ultrasound revealed that the tumor had enlarged to 12 mm in size. He was asymptomatic and had no abnormalities in other laboratory examinations, including the tumor markers, carcinoembryonic antigen and CA19-9. Abdominal ultrasound showed a 12-mm polyp in the neck of the gallbladder with perfusion and focal thickening of the gallbladder wall. A gallbladder stone was also seen in the fundus. An enhanced computed tomography scan and magnetic resonance imaging revealed a polypoid lesion and gallbladder stone located at the neck of the gallbladder and the fundus, respectively. Malignancy could not be excluded, and hence, a laparoscopic cholecystectomy was performed. Pathologically, a pedunculated polyp (14 × 11 × 15 mm) was observed in the neck of the gallbladder, and the polypoid lesion comprised nests or trabecular growths of clear NET cells in the lamina propria (ENETS: T1N0M0; AJCC: T1aN0M0). Immunohistochemical staining with synaptophysin, chromogranin A, and CD56 was confined to the tumor. The pathological diagnosis was clear cell NET G1 of the gallbladder. Although clear cell NET is often described as a distinct manifestation of von Hippel-Lindau disease (VHL), the patient had no past medical or family history of VHL. Until his one-and-a-half-year follow-up, the patient was doing well and without any signs of recurrence.
We report an extremely rare case of gallbladder clear cell NET G1. When NET G1 is incidentally identified in a gallbladder surgical specimen, clinical information and pathological findings should be considered as references.
胆囊神经内分泌肿瘤是一种罕见疾病，分为神经内分泌瘤（NETs）和神经内分泌癌（NECs）。胆囊透明细胞NETs极为罕见。我们报告一例接受腹腔镜胆囊切除术的胆囊息肉样透明细胞NET G1患者的病例。
一名60岁患有慢性肝炎和乙肝且未接受药物治疗的男性，在腹部超声随访检查中发现胆囊颈部有一个10毫米带蒂息肉。六个月后，腹部超声显示肿瘤增大至12毫米。他没有症状，其他实验室检查包括肿瘤标志物癌胚抗原和CA19-9均无异常。腹部超声显示胆囊颈部有一个12毫米息肉，伴有胆囊壁灌注和局部增厚。在胆囊底部还发现了一枚胆囊结石。增强计算机断层扫描和磁共振成像显示，息肉样病变和胆囊结石分别位于胆囊颈部和底部。无法排除恶性可能，因此进行了腹腔镜胆囊切除术。病理检查发现，在胆囊颈部观察到一个带蒂息肉（14×11×15毫米），息肉样病变由固有层中透明NET细胞的巢状或小梁状生长构成（ENETS：T1N0M0；AJCC：T1aN0M0）。突触素、嗜铬粒蛋白A和CD56的免疫组化染色局限于肿瘤。病理诊断为胆囊透明细胞NET G1。尽管透明细胞NET常被描述为冯·希佩尔-林道病（VHL）的一种独特表现，但该患者既往无VHL病史或家族史。截至他的一年半随访时，患者情况良好，无任何复发迹象。
我们报告了一例极为罕见的胆囊透明细胞NET G1病例。当在胆囊手术标本中偶然发现NET G1时，临床信息和病理结果应作为参考。
