Table 1.
Timeline of diagnostic evaluations, treatment interventions, and corresponding radiological findings in a patient with advanced small-cell neuroendocrine carcinoma of the gallbladder
| Date | Intervention | Key findings |
|---|---|---|
| Baseline evaluation | CT abdomen/pelvis | Bulky GB mass, hepatic invasion (S5–S6, S4b), lymphadenopathy (porta hepatis, para-aortic, mesenteric) |
| EGD, colonoscopy | Gastritis, multiple epithelial lesions | |
| Liver biopsy | SCNEC, synaptophysin+, chromogranin A+, Ki-67 100% | |
| | PET/CT | Marked regression, effusion resolved |
| Systemic therapy | 6 cycles cisplatin-etoposide | Tolerated, partial response |
| Interim evaluation | PET/CT | Marked regression, no new lesions |
| CT, brain MRI | Slight further shrinkage, no CNS mets | |
| Radiation therapy | hypofractionated radiotherapy (IGRT, RapidArc VMAT) | 45 Gy subclinical, 50.4 Gy gross tumor volume |
| Follow-up | PET/CT | Complete response |
| PET/CT | Residual necrotic tissue, no metabolic activity, stable |
GB, gall bladder; SCNEC, small-cell neuroendocrine carcinoma.