PMC2952924_01
Neuroendocrine tumor of the gallbladder in an otherwise asymptomatic 47-year-old male. (a) Coronal T1-weighted image shows a 7.5 x 5.4 cm irregular mass arising from the gallbladder bed. (b) Coronal T1-weight image again illustrating the large heterogeneous mass in the gallbladder fossa.
CRM2010-453624.001.jpg
PMC2952924_01_CRM2010-453624.001.jpg
fig1
An RUQ ultrasound and MRI performed revealed a heterogeneous mass arising from the gallbladder measuring 7.5 x 5.4 cm and extending into segment 4B of the liver (Figure 1).
Grossly, the intramural tumor mass occupies over 95% of the gallbladder wall and protrudes into the lumen. The tumor mass has a solid tan-red colored fleshy cut surface.
CRM2010-453624.002.jpg
PMC2952924_01_CRM2010-453624.002.jpg
fig2
Pathology was consistent with a poorly differentiated neuroendocrine carcinoma with extensive lymphovascular invasion (Figures 2 and 3).
The tumor diffusely infiltrates into the gallbladder wall and involves the mucosa. (HE) x20.
CRM2010-453624.003.jpg
PMC2952924_01_CRM2010-453624.003.jpg
fig3
Pathology was consistent with a poorly differentiated neuroendocrine carcinoma with extensive lymphovascular invasion (Figures 2 and 3).
In the higher magnification, nuclear moldings with many abnormal mitosis, apoptotic cells, and necrosis are seen. (HE) x400.
CRM2010-453624.004.jpg
PMC2952924_01_CRM2010-453624.004.jpg
fig4
Azzopardi phenomenon, a feature of small cell carcinoma, was present (Figure 4). An immunohistochemical analysis confirmed the diagnosis (Table 1).
PMC2952924_02