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@#【Objective】 To summarize the CT and MRI imaging features of gallbladder neuroendocrine tumor.【Methods】 CT and MRI data of 10 patients with gallbladder neuroendocrine tumors proven by surgical pathology between January 2010 and May 2018 were retrospectively analyzed. Among them，6 patients underwent CT examination，3 underwent MRI examination，and 1 patient underwent both CT and MRI examinations. The size，morphologic features and contrast enhancement pattern of gallbladder tumors，and the presence of liver metastasis，bile duct and perihepatic metastasis，lymph node metastasis，and the presence of gallbladder stone were assessed.【Results】Among these 10 cases of gallbladder neuroendocrine tumor，the largest dimension of tumors ranged from 39 mm to 120 mm. The tumors manifest? ed as a mass protruding into the lumen with a broad base adhering to the wall of the gallbladder. In 7 patients who had undergone CT examination，the tumors manifested as an irregular mass with soft tissue density on CT. In 4 patients who had undergone MRI，the tumors showed homogeneous iso-intense signal on T1-weightedimaging，heterogenous hyper-intense signal on T2- weighted imaging，and limited diffusion on diffusion- weighted imaging. All tumors in 10 patients showed moderate，heterogeneous and persistent enhancement. Eight patients had liver metastasis，among whom 7 had metastases in liver segments 4 and 5，and 1 had multiple metastases in other liver segments. Six patients had bile duct invasion and 3 had hilar fat invasion. Seven patients had lymph node metastasis. One patient had gallstone.【Conclusion】Gallbladder neuroendocrine tumor has certain characteristic CT and MRI findings，such as a large mass in gallbladder，which tends to invade adjacent liver parenchyma，and extend along gallbladder neck and gallbladder ducts，accompanied with hepatic portal and retroperitoneal lymph node metastasis，and hilar fat invasion.
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Objective To summarize and analyse the clinical characteristics,diagnosis and treatment options of neuroendocrine carcinoma of gallbladder (GB-NEC).Methods The data of 10 patients with GB-NEC treated in our hospital between December 2007 and December 2012 were retrospectively analyzed and compared with the data of 377 patients with gallbladder adenocarcinoma.Results The 10 patients with GB-NEC accounted for 2.2％ (10/464) of all gallbladder cancers that were treated during the study period.The mean age was 59.0 ± 10.0 years,the ratio of male to female was 1 ∶ 4.All the 10 patients had low-differentiated small cell NEC,four patients were accompanied with an adenocarcinoma.Immunohistochemical examinations showed that the positive rates of CgA,NSE,Syn,EMA were 100％ (10/10),100％ (10/10),88.9％ (8/9) and 87.5％ (7/8),respectively.One,two and seven patients had a TNM grade Ⅱ,ⅣA,and ⅣB,respectively.Seven patients (70.0％) had N2 lymphatic metastases,which was significantly higher than the percentage in patients with gallbladder adenocarcinoma (128/377,34.0％ ; P ＜ 0.05).Two patients were treated with radical resection,while the other 8 patients were treated with palliative surgery.The 1-,2-,and 3-year survival rates of the patients with GB-NEC were 20.0％,10.0％,and 0,respectively.The median survival time was 92 days.In contrast,the 1-,2-,3-,and 5-year survival rates of the 377 patients with gallbladder adenocarcinoma were 32.7％,25.4％,21.3％,and 11.7％ respectively,and the median survival time was 180 days.Condusions GB-NEC was found mainly in aged females.The clinical presentations were mainly non-specific,and immunohistochemical examinations were needed for a definite diagnosis.GB-NEC is highly malignant,and local invasion and lymphatic metastasis could occur early.The short-term recurrence rate was very high.The prognosis of GB-NEC was poorer than gallbladder adenocarcinoma,while surgical resection combined with radiotherapy,chemotherapy and TACE increased the survival of these patients.
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Objective To review the imaging appearances and clinical symptoms of primary hepatic and gallbladder neuroendocrine carcinomas (PHGNC). Methods Five patients (4 females and 1 male) were examined. Long-term diarrhea not controlled by drug was found in four patients, and two of them accompanied by abdominal pain. The liver rupture occurred in one case due to the huge tumor bleeding. Five patients were examined by using ultrasonography (US), four patients by CT, and three patients by hepatic angiography. The tumor originated from liver in three cases, from liver and gallbladder in one case, and from gallbladder in one case. The tumors were diagnosed by surgery in 3 cases, by biopsy and by autopsy in 1 case, respectively. Results Multiple hyperechoic inhomogeneous masses in two cases and hypoechoic inhomogeneous masses in one case were revealed, all with some small fluid areas and abundant vessels. A huge cyst-solid tumor was clearly demonstrated by using US. A small mural nodule along the gallbladder wall was displayed by using US in a gallbladder tumor, and it showed no specific sign in the diagnosis. CT findings included hypodense inhomogeneous masses on plain CT scan, and slightly enhanced masses with some small fluid areas after injection of contrast agent. A huge cyst-solid tumor was clearly displayed by CT due to the hemorrhage, necrosis, and cystic changes in the tumor. Hepatoangiography displayed abundant vessels and stain in the solid part of the tumor, and absent vessel in the cystic region of the cyst-solid tumor accompanied by dislocation of surrounding vessels. Conclusion Imaging appearances of the liver tumor were inhomogeneous mass with abundant vessels and tumor stains. Imaging appearances of the gallbladder tumor were raised mural nodule along the gallbladder wall without specific sign in the diagnosis of the tumor. The tumor may develop hemorrhage, necrosis, and cystic changes if it is large enough. PHGNC was prone to hepatic metastases. The patients often presented with diarrhea and abdominal pain.