[A Case of Biliary Neuroendocrine Tumor with Neo Adjuvant Chemotherapy]

A 65-year-old man was diagnosed with biliary carcinoma. Abdominal CT showed a tumor at the inferior bile duct. Tumor cells with small cell carcinoma were confirmed with biopsy of ERCP. Although the tumor seemed to be resectable, ERCP caused pancreatitis. We decided to perform surgery after the pancreatitis had healed to initiate neoadjuvant chemotherapy. According to the guideline of pancreatic NET(G3), we adopted the regimen of CDDP plus VP-16. After 2 courses, CT revealed that there were no changes in tumor size and that the pancreatitis was healing. We then performed pancreatoduodenectomy. Histological examination of the specimen demonstrated small cell NEC of the bile duct. Five months after the operation, multiple liver metastases manifested, leading to liver failure and death. NEC of the bile duct is known to be a highly malignant tumor with a poor prognosis. Further evaluation is needed to elucidate optimal therapy for biliary NEC.