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胆囊原发性高分化神经内分泌肿瘤:1例误诊病例

Gallbladder primary well-differentiated neuroendocrine tumor: A misdiagnosed case.

作者信息

Dammak Nouha, Ammar Houssem, Latifa Mahdi Ben, Belkacem Oussama, Mabrouk Mohamed Ben, Ali Ali Ben

机构信息

Department of Digestive and Visceral Surgery, Sahloul University Hospital, Sousse, Tunisia.

Department of Digestive and Visceral Surgery, Sahloul University Hospital, Sousse, Tunisia.

出版信息

Int J Surg Case Rep. 2023 Oct;111:108882. doi: 10.1016/j.ijscr.2023.108882. Epub 2023 Oct 1.

Abstract

INTRODUCTION

Gallbladder (GB) Well-Differentiated (WD) Neuroendocrine Tumor (NET) are extremely rare tumors. They represent only about 0.5 % of all Neuroendocrine Neoplasms (NENs). Most GB-NETs are diagnosed after cholecystectomy. They are often misdiagnosed and have good prognosis.

CASE PRESENTATION

We share our experience of a 42-year-old woman operated on for symptomatic cholelithiasis. We discover on the anatomopathological piece that it was a Grade 1 NET of the GB. Staging scans and octreotide-scans were normal: there is no distant or nodal metastasis. This tumor was classified as T1bN0M0. After multidisciplinary team discussion, additional treatment is deemed unnecessary. She didn't receive any treatment after the surgery. At one year after the cholecystectomy, she is symptom free and there is no sign of recurrence.

DISCUSSION

The diagnosis of GB-WD NET is difficult at the first evaluation. Surgical management for GB cancer has shown increased survival rates, a similar strategy seems reasonable for GB-NETs. Patients with Grade,1 well-differentiated GB-NETS have an excellent prognosis overall.

CONCLUSION

Research is required to facilitate earlier diagnosis and to develop management guidelines for GB-NETs.

摘要

引言

胆囊(GB)高分化(WD)神经内分泌肿瘤(NET)极为罕见。它们仅占所有神经内分泌肿瘤(NENs)的约0.5%。大多数GB-NETs在胆囊切除术后被诊断出来。它们常被误诊,但预后良好。

病例报告

我们分享了一名因有症状的胆结石接受手术的42岁女性的病例。我们在病理切片上发现这是一例GB的1级NET。分期扫描和奥曲肽扫描均正常:无远处或淋巴结转移。该肿瘤被分类为T1bN0M0。经过多学科团队讨论,认为无需进一步治疗。她术后未接受任何治疗。胆囊切除术后一年,她无症状,也无复发迹象。

讨论

GB-WD NET在初次评估时诊断困难。GB癌的手术治疗已显示出生存率提高,类似的策略对GB-NETs似乎也是合理的。1级高分化GB-NETs患者总体预后良好。

结论

需要开展研究以促进GB-NETs的早期诊断并制定管理指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff1c/10551650/f3b9ca5c7c4e/gr1.jpg

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