A case of stage IV gallbladder neuroendocrine carcinoma suggested by biliary cytological findings

Abstract

A 56-year-old man was admitted to our hospital with jaundice. Imaging findings were suspicious for advanced gallbladder cancer that was considered inoperable due to multiple liver and lymph nodal metastasis. Endoscopic retrograde cholangiopancreatography (ERCP) was performed to confirm the diagnosis before chemotherapy, followed by endoscopic biliary drainage. ERCP revealed pancreaticobiliary maljunction. Bile cytology and biliary brush cytology demonstrated aggregates of small atypical cells in a "molding" and "Indian file" pattern. Based on the cytology results, an additional percutaneous liver biopsy was performed and revealed a neuroendocrine carcinoma (NEC). The patient received carboplatin plus etoposide treatment, and stable disease was achieved for approximately three months. Hence, biliary cytology was useful for the therapeutic decision-making for this patient with advanced gallbladder carcinoma containing NEC.