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胆囊神经内分泌癌合并乙状结肠腺癌:1例罕见病例报告

Neuroendocrine carcinoma of the gallbladder concomitant with adenocarcinoma of the sigmoid colon: A rare case report.

作者信息

Chablou Mohamed, Mabrouk Yassine, Maamar Khalil, Jabi Rachid, Bouziane Mohammed

机构信息

General Surgery Department, Mohammed VI University Hospital/Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco.

出版信息

Ann Med Surg (Lond). 2021 May 6;66:102359. doi: 10.1016/j.amsu.2021.102359. eCollection 2021 Jun.

Abstract

INTRODUCTION AND IMPORTANCE

Neuroendocrine carcinoma of the gallbladder is rare and aggressive, its diagnosis is based on pathologic and immunohistochemical examination, currently there is no standard treatment for this tumor. Its concomitant occurrence with adenocarcinoma of the sigmoid colon is exceptional.

CASE PRESENTATION

This case report describes a rare case of neuroendocrine carcinoma of the gallbladder that occurred concomitantly with sigmoid colon adenocarcinoma. The diagnosis of neuroendocrine carcinoma was established postoperatively by pathological and immunohistochemical examination. The biopsy of the colonic process confirmed the preoperative diagnosis. A laparotomy found a vesicular fundus process, peri-hilar adenopathy, metastasis of the liver segment V, and a sigmoid colon process. The patient underwent a cholecystectomy extended to segments IVb and V, with lymph node dissection and sigmoid colectomy. The postoperative follow-up was uneventful, and the length of hospitalization was seven days. The patient is currently undergoing adjuvant chemotherapy.

DISCUSSION

Neuroendocrine carcinoma of the gallbladder is extremely rare, with few case reports, its occurrence concomitantly with adenocarcinoma of the sigmoid colon is exceptional. Histology and immunohistochemistry confirm the diagnosis, surgery is essential in the management of patients affected by this tumor. The presence of synchronous metastases causes doubt about their primitive, hence the primordial place of surgery and histological examination to adopt adequate management of the patients.

CONCLUSION

We underline the rarity of this neuroendocrine tumor and the importance of histology and surgery in its management.

摘要

引言与重要性

胆囊神经内分泌癌罕见且具有侵袭性,其诊断基于病理和免疫组化检查,目前该肿瘤尚无标准治疗方法。它与乙状结肠腺癌同时发生的情况极为罕见。

病例介绍

本病例报告描述了一例罕见的胆囊神经内分泌癌与乙状结肠腺癌同时发生的病例。神经内分泌癌的诊断在术后通过病理和免疫组化检查得以确立。结肠病变的活检证实了术前诊断。剖腹探查发现胆囊底部有囊状病变、肝门周围淋巴结肿大、Ⅴ段肝转移以及乙状结肠病变。患者接受了扩大至Ⅳb和Ⅴ段的胆囊切除术、淋巴结清扫术以及乙状结肠切除术。术后随访顺利,住院时间为7天。患者目前正在接受辅助化疗。

讨论

胆囊神经内分泌癌极其罕见,病例报告较少,它与乙状结肠腺癌同时发生的情况极为罕见。组织学和免疫组化可确诊,手术对于此类肿瘤患者的治疗至关重要。同时存在转移灶会让人对其原发部位产生怀疑,因此手术和组织学检查对于采取适当的患者管理至关重要。

结论

我们强调这种神经内分泌肿瘤的罕见性以及组织学和手术在其治疗中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd14/8131395/de2d63235261/gr1.jpg

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