A case of early neuroendocrine carcinoma of the gallbladder with extensive intraductal extension

We present a case of early neuroendocrine carcinoma of the gallbladder with bile duct extension. A 70-year-old woman with a chief complaint of appetite loss was admitted to our hospital with a diagnosis of obstructive jaundice caused by a gallbladder tumor. Abdominal CT showed the gallbladder wall was irregularly thickened and the extrahepatic bile duct was contiguously filled with the tumor. Tumor biopsy under endoscopic retrograde cholangiography revealed neuroendocrine carcinoma. We performed extrahepatic bile duct resection and cholecystectomy with choledochoduodenostomy. Immunochemical examination revealed synaptophysin (+), chromogranin A (+) and an MIB-I labeling index 70%, which confirmed large cell neuroendocrine carcinoma as defined by the WHO classification, 2010. The final diagnosis was fT1 (fm, pHinf0, pBinf0, pV0, pA0), N0 (0/1), INFα, ly1, v0, pN0, H0, P0, M (-) Stage I. The postoperative course of the patient was uneventful and she was recurrence free 14 months after the operation.