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Brain metastasis from gallbladder neuroendocrine carcinoma
Hanako Sasaki1, Takayoshi Goto2, Motohiro Hirao3
1Neurosurgery, Osaka Rosai Hospital, Sakai, Osaka, Japan hanakos444@gmail.com.
BMJ Case Reports
|December 1, 2020
Summary
A patient with advanced gallbladder neuroendocrine carcinoma (GB-NEC) showed tumor regression after chemotherapy, allowing for surgery. However, brain metastases developed, highlighting the need for targeted therapies and surveillance in advanced GB-NEC cases.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- Neuroendocrine carcinomas (NECs) of the gallbladder are rare and aggressive malignancies.
- Advanced gallbladder neuroendocrine carcinoma (GB-NEC) presents significant treatment challenges.
Observation:
- A 52-year-old woman with unresectable GB-NEC received irinotecan plus cisplatin chemotherapy.
- Radiological scans showed tumor regression and resolution of metastases, enabling laparoscopic cholecystectomy.
- Post-surgery, the patient developed multiple hemorrhagic brain metastases (BMs) and succumbed to the disease.
Findings:
- Pathological examination of the resected gallbladder revealed adenocarcinoma components, suggesting chemotherapy eradicated the NEC component.
- The brain metastases were confirmed to be neuroendocrine carcinoma.
- This case suggests a potential shift in tumor histology post-chemotherapy.
Implications:
- Conversion surgery may be a viable option for advanced GB-NEC following successful neoadjuvant chemotherapy.
- The emergence of NEC in brain metastases underscores the importance of systemic screening and potentially second-line therapies.
- Further research into the histopathological evolution of GB-NEC under treatment is warranted.
