Ben Rejeb Sarra, Chaabane Yasmine, Sahnoun Moez, Chouchen Adnen
Pathology Department, Security Forces Hospital, Marsa, Tunisia.
Pathology Department, Security Forces Hospital, Marsa, Tunisia.
Int J Surg Case Rep. 2025 Jun;131:111367. doi: 10.1016/j.ijscr.2025.111367. Epub 2025 Apr 25.
Neuroendocrine tumors (NETs) of the gallbladder are rare, often discovered incidentally, with unclear pathogenesis and management strategies.
A 51-year-old man with hypertension presented with abdominal pain and a positive Murphy's sign. After laparoscopic cholecystectomy for suspected acute cholecystitis, histopathology revealed a grade 1 NET at the cystic duct margin, invading the subserosa (pT2). Staging showed no metastases, though pericholedochal lymph nodes were enlarged. A second surgery resected the cystic duct and regional lymph nodes, revealing no residual tumor. No adjuvant therapy was given, and the patient remains disease-free at 5 years.
Gallbladder NETs often mimic common biliary conditions, making the preoperative diagnosis challenging due to nonspecific findings. This case highlights the pathology's key role in the diagnosis of asymptomatic early-stage tumors and suggests a favorable prognosis for well-differentiated NETs with surgical management, despite unclear adjuvant therapy guidelines.
NETs of the gallbladder are uncommon with nonspecific clinical and imaging features. This rare case emphasizes the importance of routine pathological examination of gallbladder specimens in detecting and grading of asymptomatic and early stage tumors such as NETs.
胆囊神经内分泌肿瘤（NETs）较为罕见，常为偶然发现，其发病机制和治疗策略尚不清楚。
一名51岁的高血压男性患者出现腹痛，墨菲氏征阳性。因疑似急性胆囊炎行腹腔镜胆囊切除术后，组织病理学检查显示在胆囊管切缘有1级NET，侵犯浆膜下层（pT2）。分期检查显示无转移，尽管肝门周围淋巴结肿大。二次手术切除了胆囊管和区域淋巴结，未见残留肿瘤。未给予辅助治疗，患者5年来无疾病复发。
胆囊NETs常与常见的胆道疾病相似，由于表现不具特异性，术前诊断具有挑战性。该病例突出了病理学在无症状早期肿瘤诊断中的关键作用，并提示尽管辅助治疗指南尚不清楚，但对于手术治疗的高分化NETs预后良好。
胆囊NETs并不常见，具有非特异性的临床和影像学特征。这个罕见病例强调了对胆囊标本进行常规病理检查在检测和分级NETs等无症状早期肿瘤中的重要性。
