2023 Volume 37 Issue 2 Pages 246-251
The patient was a 77-year-old female who presented with a mass measuring 90mm long diameter close to the pancreatic head, which was identified incidentally on CT. Based on an EUS-FNA histological examination, the patient was diagnosed with duodenal neuroendocrine carcinoma (NEC), and subtotal stomach-preserving pancreatoduodenectomy was performed. The histopathological assessment showed some lymphatic tissue remaining in the mass, so lymph node metastasis was suspected. The mass consisted mainly of NEC components, and also had adenocarcinomatous and chondrosarcomatous components. The excised specimen showed a nodular lesion was found in the fundus of the gallbladder, and histopathologically it was composed of adenocarcinomatous and chondrosarcomatous components. Metastasis was also found in No.12c lymph node, with only NEC components present. Based on these findings, a diagnosis of gallbladder sarcoma with differentiation to NEC during lymph node metastasis was made. We report this case because it presents an interesting metastatic form and is considered to be a valuable case in terms of tumorigenesis.
