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Liver Tumor Encapsulating the Gallbladder

  • Chia-Chu Fu
    Affiliations
    Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Nai-Chi Chiu
    Affiliations
    Department of Radiology, Taipei Veterans General Hospital School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
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  • Chien-Wei Su
    Correspondence
    Correspondence: Address correspondence to: Chien-Wei Su, MD, PhD, Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Peitou District, Taipei 11217, Taiwan.
    Affiliations
    Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Hospitalist Ward, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Biomedical Science and Engineering Center, National Tsing Hua University, Hsinchu, Taiwan
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Open AccessPublished:July 18, 2022DOI:https://doi.org/10.1016/j.gastha.2022.07.011
      A 68-year-old man presented with abdominal fullness and icterus. Laboratory data showed hyperbilirubinemia (total bilirubin: 8.2 mg/dL) and elevated liver enzyme (alanine aminotransferase: 607 U/L). Tumor markers revealed only mild elevation of carbohydrate antigen (CA-199: 107 U/mL). Computed tomography scan indicated a well-defined mass at the gallbladder fossa and multiple hypodense lesions in both lobe of liver (Figure A and Figure B). Liver biopsy was arranged. The pathology report revealed medium-size round cells with hyperchromatic and pleomorphic nuclei (Figure C). Immunostaining was positive for synaptophysin (Figure D). The morphological features were compatible with metastatic neuroendocrine neoplasm. For primary origin survey, esophagogastroduodenoscopy, colonoscopy, chest computed tomography scan, and small intestine barium studies were arranged but showed no remarkable finding, suspected primary hepatic neuroendocrine neoplasm. The patient received concurrent chemoradiotherapy with cisplatin and etoposide, and consequently, regressive disease was found after treatment.