PMID- 26208508
OWN - NLM
STAT- MEDLINE
DCOM- 20160913
LR  - 20181113
IS  - 1941-6636 (Electronic)
VI  - 46
IP  - 4
DP  - 2015 Dec
TI  - Neuroendocrine Carcinoma of Gall Bladder: A Series of 19 Cases with Review of 
      Literature.
PG  - 356-64
LID - 10.1007/s12029-015-9745-9 [doi]
AB  - BACKGROUND: Neuroendocrine neoplasms of the gall bladder (GB) are rare tumors 
      classified as grade 1 and 2 neuroendocrine tumor (NET), neuroendocrine carcinoma 
      (large cell or small cell type), and mixed adeno-neuroendocrine carcinoma 
      (MANEC). Primary neuroendocrine carcinomas (NEC) of GB are rare with grave 
      prognosis not withstanding radical surgical treatment. Chemotherapy forms the 
      primary management due to the advanced stage at presentation, as complete 
      surgical resection is generally not possible. The overall median survival is 4-6 
      months despite aggressive management. Only 73 cases of small cell carcinoma (SCC) 
      and 10 cases of large cell neuroendocrine carcinoma (LCNEC) have been reported in 
      English literature till now. We present a series of 19 cases of NEC of GB with 
      their pathological and clinical features and response to treatment. OBJECTIVE: 
      The objective of this study was to evaluate NECs of the GB for their clinical 
      behavior, prognosis, and treatment outcome in terms of survival and to segregate 
      NECs into further subcategories, that is 20-50 % and >50 %, based on MIB-1 index. 
      METHODS: We retrospectively searched the clinical and pathological database over 
      2.5 years (January 2012 to June 2014) through existing electronic hospital 
      medical records to collect cases of NEC arising in GB. A total of 447 cases of 
      gall bladder pathologies were analyzed, of which 19 cases were diagnosed as NEC. 
      All relevant investigations were documented and response to treatment/therapy was 
      evaluated clinically and radiologically. Tumor specimen was obtained by 
      fine-needle aspiration cytology and/or biopsy and classified using the latest 
      World Health Organisation (WHO) classification (2010) via cytopathologic, 
      histopathologic, and immunohistochemical visage. RESULTS: Nineteen patients 
      diagnosed as NEC of GB were evaluated in the study, with 16 having SCC, 2 having 
      LCNEC, and 1 with MANEC. All patients presented in advanced clinical stage III or 
      IV, along with distant metastasis and showed progressive disease during therapy. 
      Ki67 index was between 20 and 50 % in 5 cases and >50 % in 8 cases. Follow-up was 
      available in 14 cases with a median survival of 3 months, and 2 of these patients 
      capitulated to their illness, before commencement of treatment. The remaining 5 
      cases were lost to follow-up. Out of these, 2 had deranged liver function test 
      and no chemotherapy could be administered, and the other 3 refused treatment. 
      CONCLUSIONS: NECs are aggressive with generally poor prognosis, characterized by 
      insidious onset and advanced clinical stage of presentation. A radical approach 
      to treatment with chemotherapy is the best form of palliation. Role of 
      radiotherapy remains undefined due to paucity of data.
FAU - Kamboj, Meenakshi
AU  - Kamboj M
AD  - Department of Histopathology and Cytopathology, Rajiv Gandhi Cancer Institute and 
      Research Centre, Delhi, India.
FAU - Gandhi, Jatin Sundersham
AU  - Gandhi JS
AD  - Department of Histopathology and Cytopathology, Rajiv Gandhi Cancer Institute and 
      Research Centre, Delhi, India. jgandhi79@gmail.com.
FAU - Gupta, Gurudutt
AU  - Gupta G
AD  - Department of Histopathology and Cytopathology, Rajiv Gandhi Cancer Institute and 
      Research Centre, Delhi, India.
FAU - Sharma, Anila
AU  - Sharma A
AD  - Department of Histopathology and Cytopathology, Rajiv Gandhi Cancer Institute and 
      Research Centre, Delhi, India.
FAU - Pasricha, Sunil
AU  - Pasricha S
AD  - Department of Histopathology and Cytopathology, Rajiv Gandhi Cancer Institute and 
      Research Centre, Delhi, India.
FAU - Mehta, Anurag
AU  - Mehta A
AD  - Department of Histopathology and Cytopathology, Rajiv Gandhi Cancer Institute and 
      Research Centre, Delhi, India.
FAU - Chandragouda, D
AU  - Chandragouda D
AD  - Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research 
      Centre, Delhi, India.
FAU - Sinha, Rupal
AU  - Sinha R
AD  - Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New 
      Delhi, India.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Gastrointest Cancer
JT  - Journal of gastrointestinal cancer
JID - 101479627
RN  - 0 (Biomarkers, Tumor)
SB  - IM
MH  - Adenocarcinoma/mortality/*pathology/therapy
MH  - Adult
MH  - Aged
MH  - Biomarkers, Tumor/metabolism
MH  - Carcinoma, Neuroendocrine/mortality/*pathology/therapy
MH  - Carcinoma, Squamous Cell/mortality/*pathology/therapy
MH  - Combined Modality Therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Gallbladder Neoplasms/mortality/*pathology/therapy
MH  - Humans
MH  - Immunoenzyme Techniques
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survival Rate
OTO - NOTNLM
OT  - Gall bladder
OT  - Neuroendocrine carcinoma
OT  - Small and large cell type
EDAT- 2015/07/26 06:00
MHDA- 2016/09/14 06:00
CRDT- 2015/07/26 06:00
PHST- 2015/07/26 06:00 [entrez]
PHST- 2015/07/26 06:00 [pubmed]
PHST- 2016/09/14 06:00 [medline]
AID - 10.1007/s12029-015-9745-9 [pii]
AID - 10.1007/s12029-015-9745-9 [doi]
PST - ppublish
SO  - J Gastrointest Cancer. 2015 Dec;46(4):356-64. doi: 10.1007/s12029-015-9745-9.