Poorly differentiated large cell neuroendocrine carcinoma of the gallblader

Introduction: Neuroendocrine tumors (NET) of the gallbladder are rare. Only 0.2% of all NET Of the digestive system are localized in the gallbladder. We report an exceptional case of poorly differentiated large cell neuroendocrine carcinoma of the gallbladder (LCNEC).
Observation: A 54-year-old man, admitted for hepatic colic evolving for 16 months. The ultrasound and the scanner are objectived a vesicular multilithiasic. Cholecystectomy by celoscopy was performed. The pathological study concluded with poorly differentiated a large cell neuroendocrine carcinoma confirmed by the immunohistochemical study.
Discussion: With only eight cases reported in the literature, LCNEC of the gallbladder, part of the NET group, is exceptional. It is probably derived from cells of the diffus neuroendocrine system (DNES) in a context of chronic inflammation by vesicular lithiasis. The diagnosis of certainty is the pathological and immunohistochemical study. This tumor is often diagnosed fortuitously during cholecystectomy for vesicular lithiasis in the few cases described in the literature. The treatment is essentially surgical. The indication of adjuvant therapy is discussed according to the prognostic factors. The survival at 5 years is 8, 3 %.
Conclusion: Our study give more importance of systematic histological examination of all cholecystectomy specimens. The pathological study remains the only way to confirm the diagnosis, to establish staging and to guide the therapeutic approach.