Open Access

Mixed adenoendocrine carcinoma in the extrahepatic biliary tract: A case report and literature review

  • Authors:
    • Liang Zhang
    • Zhengtao Yang
    • Qing Chen
    • Mengxia Li
    • Xiaolu Zhu
    • Dalong Wan
    • Haiyang Xie
    • Shusen Zheng
  • View Affiliations

  • Published online on: June 20, 2019     https://doi.org/10.3892/ol.2019.10502
  • Pages: 1585-1596
  • Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Neuroendocrine neoplasm (NEN) comprises a group of tumors that exhibit neuroendocrine phenotypes. NEN is subclassified into neuroendocrine tumor (NET), neuroendocrine carcinoma (NEC) and mixed adenoendocrine carcinoma (MANEC), based on histopathological parameters. NEN in the extrahepatic biliary tract (EHBT) is uncommon. Little is known about its clinicopathological features and prognostic indicators. The present study presented a case of MANEC in the distal common bile duct (CBD) and reviewed previous cases of NENs in the EHBT to characterize the clinical settings of this disease entity and to identify influencing factors of survival outcomes. A 64‑year‑old Chinese woman presented with abdominal pain and jaundice. Imaging studies demonstrated malignant stenosis in the distal CBD. Bile duct brush cytology revealed small clusters of atypical cells. Following an initial diagnosis of distal cholangiocarcinoma (CCA), the patient underwent pancreaticoduodenectomy. Histological analysis combined with immunohistochemical investigation of the resected specimen revealed a collision tumor that was composed of poorly differentiated adenocarcinoma and NEC. Each histological component accounted for >30% of the tumor. The definitive diagnosis was a MANEC in the distal CBD. Multiple intrahepatic and pulmonary metastases were observed postoperatively over 8 months. The patient succumbed to the disease 12 months after surgery. In conclusion, NEN occurs infrequently in the EHBT, with NET being the predominant type. NEN in the EHBT is extremely challenging to diagnose preoperatively due to its tendency to mimic CCA. Patients with NEN in the EHBT exhibited extremely distinct oncology outcomes according to pathological types. Additionally, old age (>60 years) and the presence of tumor recurrence were associated with decreased survival of patients with NEN.
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August-2019
Volume 18 Issue 2

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Zhang L, Yang Z, Chen Q, Li M, Zhu X, Wan D, Xie H and Zheng S: Mixed adenoendocrine carcinoma in the extrahepatic biliary tract: A case report and literature review. Oncol Lett 18: 1585-1596, 2019
APA
Zhang, L., Yang, Z., Chen, Q., Li, M., Zhu, X., Wan, D. ... Zheng, S. (2019). Mixed adenoendocrine carcinoma in the extrahepatic biliary tract: A case report and literature review. Oncology Letters, 18, 1585-1596. https://doi.org/10.3892/ol.2019.10502
MLA
Zhang, L., Yang, Z., Chen, Q., Li, M., Zhu, X., Wan, D., Xie, H., Zheng, S."Mixed adenoendocrine carcinoma in the extrahepatic biliary tract: A case report and literature review". Oncology Letters 18.2 (2019): 1585-1596.
Chicago
Zhang, L., Yang, Z., Chen, Q., Li, M., Zhu, X., Wan, D., Xie, H., Zheng, S."Mixed adenoendocrine carcinoma in the extrahepatic biliary tract: A case report and literature review". Oncology Letters 18, no. 2 (2019): 1585-1596. https://doi.org/10.3892/ol.2019.10502