Gallbladder primary neuroendocrine carcinoma liver metastasis that was difficult to differentially diagnose from gallbladder cancer liver metastasis and hepatocellular carcinoma

Abstract

An 81-year-old-female was hospitalized for acute liver injury. Computed tomography (CT) showed thickening of the gallbladder fundus, and liver biopsy revealed autoimmune hepatitis/primary biliary cholangitis overlap syndrome. CT revealed an irregular stained mass in the gallbladder fundus and 2 low-density areas at segment 5 in the liver 2 years later.

For differential diagnosis of gallbladder cancer liver metastasis and hepatocellular carcinoma from elevated AFP, CT during portography and hepatic arteriography were performed. Surgical resection was performed post two intra-arterial infusion chemotherapy. Histopathological diagnosis was neuroendocrine carcinoma (NEC) and NEC liver metastasis. Neuroendocrine cancer of the gallbladder is a very rare disease, and no consensus exists on diagnostic methods and treatments. We came upon a case in which tumor shrinkage was observed by hepatic arterial infusion and surgical resection could be diagnosed as gallbladder NEC liver metastasis.