Brain metastasis from gallbladder neuroendocrine carcinoma

BMJ Case Rep. 2020 Nov 30;13(11):e238114. doi: 10.1136/bcr-2020-238114.


A 52-year-old woman was diagnosed with unresectable gallbladder neuroendocrine carcinoma (GB-NEC) exhibiting lymph node and peritoneal metastases, and received eight courses of chemotherapy with irinotecan plus cisplatin. Radiological examinations revealed significant regression of the GB tumour and disappearance of metastatic lesions, so the patient underwent laparoscopic cholecystectomy. However, the patient presented with multiple haemorrhagic brain metastases (BMs) and died 13 months after the initial diagnosis despite neurosurgical interventions. Pathological examination of the resected gallbladder demonstrated an extensive fibrous scar along with tubular adenocarcinoma components, which may indicate that the chemotherapy eliminated a pre-existing neuroendocrine carcinoma (NEC) component. Furthermore, pathological analysis confirmed that the BMs comprised NEC. In patients with advanced GB-NEC, conversion surgery may be a reasonable option if a first-line chemotherapy leads to downstaging of the tumour. Second-line drug therapy and systemic screening might also be considered in cases with BMs.

Keywords: endocrine cancer; neuroendocrinology.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Brain / diagnostic imaging
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / surgery
  • Carcinoma, Neuroendocrine / drug therapy
  • Carcinoma, Neuroendocrine / pathology
  • Carcinoma, Neuroendocrine / secondary*
  • Cholecystectomy, Laparoscopic
  • Combined Modality Therapy
  • Fatal Outcome
  • Female
  • Gallbladder / pathology
  • Gallbladder Neoplasms / drug therapy
  • Gallbladder Neoplasms / pathology*
  • Gallbladder Neoplasms / surgery
  • Humans
  • Middle Aged
  • Radiography, Abdominal
  • Tomography, X-Ray Computed


  • Antineoplastic Agents