World Journal of Surgical Oncology (Jul 2019)

Repeat liver resection for pure large cell neuroendocrine carcinoma of the gallbladder: a favorable outcome

  • Ahmad Abutaka,
  • Moamena El-Matbouly,
  • Irfan Helmy,
  • Walid Elmoghazy,
  • Ibnouf Sulieman,
  • Mohamed Ben Gashir,
  • Madiha Soofi,
  • Hatem Khalaf,
  • Ahmed Elaffandi

DOI
https://doi.org/10.1186/s12957-019-1666-9
Journal volume & issue
Vol. 17, no. 1
pp. 1 – 6

Abstract

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Abstract Background The pure large cell type is a rare variant of primary neuroendocrine carcinoma of the gallbladder. Few reports have mentioned extended survival. Although a multimodal treatment has been described in the treatment of such rare disease, redo liver resection has not yet been mentioned. Case report A 67-year-old lady was found to have poorly differentiated, high grade, pure large cell neuroendocrine tumor of the gallbladder after cholecystectomy for gallstones. After the diagnosis, staging workup showed a lesion in segment IVB/V of the liver, and chromogranin was elevated (982 mcg/L). The patient underwent central inferior hepatectomy and wedge excision of a lesion in segment III (discovered intra-operatively), with hilar lymphadenectomy. Three months after the first liver resection, she developed a new liver lesion II/III and underwent left lateral liver resection. The patient remained disease-free for 4 months following the second liver resection but then developed recurrent liver disease and was started on chemotherapy. Further progression led to multi-organ failure and death at 26 months from initial diagnosis. Conclusion This is the first reported repeat liver resection in such a rare disease that has led to extended overall survival. We suggest that a group of selected patients with this rare malignancy, and liver-limited disease, may benefit from repeated liver resection.

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