[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-385221-105":59,"doc-detail-385221-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","effective-treatment-of-gallbladder-neuroendocrine-carcinoma-with-nivolumab","Effective treatment of gallbladder neuroendocrine carcinoma with nivolumab","","A case report describes an 89-year-old man with gallbladder neuroendocrine neoplasms and lung cancer metastasis who underwent nivolumab monotherapy. During treatment, FDG uptake on PET-CT localized to the gallbladder fundus and multiple lymph node stations, and biopsy via EUS-FNA supported small-cell neuroendocrine carcinoma consistent with primary gallbladder origin. After 10 courses, the gallbladder tumor shrank, lymphadenopathy near the hepatoduodenal ligament diminished, NSE normalized, and nivolumab was followed by surgery with adjuvant nivolumab despite low PD-L1 expression.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/effective-treatment-of-gallbladder-neuroendocrine-carcinoma-with-nivolumab/385221/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/effective-treatment-of-gallbladder-neuroendocrine-carcinoma-with-nivolumab/385221.png","ImageObject",300,407,{"name":92,"@type":93},"Grenda","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What treatment was used for the patient’s gallbladder neuroendocrine carcinoma?","Question",{"text":112,"@type":113},"The patient received nivolumab monotherapy (240 mg every 2 weeks), followed by surgery and adjuvant nivolumab.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the diagnosis clarified before treatment?",{"text":117,"@type":113},"Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of lymph nodes in the hepatoduodenal ligament identified small-cell neuroendocrine carcinoma, supporting primary gallbladder cancer with lymph node metastasis rather than lung adenocarcinoma metastasis.",{"name":119,"@type":110,"acceptedAnswer":120},"What clinical and imaging changes occurred after nivolumab?",{"text":121,"@type":113},"After 10 courses, CT showed shrinkage of the gallbladder tumor with limited residual lymphadenopathy, and neuron-specific enolase (NSE) turned negative.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},385221,1790318852,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},7971474921005,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","DOI: 10. 1002/ccr3 .8040  \nCASE REPORT  \nEffective treatment of gallbladder neuroendocrine carcinoma with nivolumab  \nShinichiro Kanda1  | Kazuhiro Hiyama2  | Izumi Kirino2 | Yasuo Fukui2 | Hideo Terashima2  \n1Kochi Medical School (KMS), Kochi University, Kochi, Japan 2Department of Surgery, Atagi Hospital, Kochi, Japan  \nCorrespondence  \nKazuhiro Hiyama, Department of Surgery, Atago Hospital, 1-1-13, Atagomachi, Kochi, Japan. [Email:](Email: kazuhirohiyama@gmail.com)[ kazuhirohiyama@gmail.com](Email: kazuhirohiyama@gmail.com)  \n1 | INTRODUCTION  \nKey clinical message  \nAn 89-year-old patient with gallbladder neuroendocrine neoplasms (GB-NENs) and lung cancer metastasis underwent nivolumab monotherapy, resulting in tumor shrinkage. Surgery and adjuvant nivolumab showed efficiency despite low expression of PD-L1 .  \nKEYWORDS  \nEUS-FNA, gallbladder NEC, immune checkpoint inhibitors  \nthere has been only one report suggesting effectiveness of nivolumab.13 Here, we report a case involving successful  \nNeuroendocrine neoplasms (NENs) often occur in the pancreas (P-NENs) and gastrointestinal tract (GINENs) .1 Gallbladder (GB) NENs are rare and account for only 0.5% of all NENs and 2% of all gallbladder tumors.2 Diagnosing GB-NENs before surgery is challenging due to a lack of specific manifestations, and to radiological findings that resemble those of other GB tumors. Most GB-NENs are detected incidentally during histological examination of GB samples after surgical removal, often performed during cholecystectomy for cholecystitis, or for suspected biliary malignancy.3–8  \nAlthough there is no consensus on the treatment of gallbladder neuroendocrine tumors, early in situ GBNENs typically respond favorably to cholecystectomy alone, whereas late-stage tumors require radical surgeries involving lymph node dissection and potential removal of nearby metastatic lesions.9,10 Currently, there are no diagnostic imaging findings for GB-NENs. Platinum-based therapeutants are generally recommended for GB-NENs, however, their efficacy is unfavorable.11 Furthermore, patients with GB-NENs have poor prognosis.12 To date,  \ntreatment of a GB-NEN with nivolumab.  \n2 | CASE HISTORY/ EXAMINATION  \nAn 89-year-old Japanese man presented to our department with gallbladder cancer. He had no disability nor any signs of cognitive dysfunction.  \nHe had been suffering from left upper lobe (S1+2) lung cancer (papillary adenocarcinoma, pT3N2M0, pStage IIIB). Left upper lobectomy with regional and left mediastinal lymphadenectomy had been performed 3 years prior, but was followed by mediastinal lymph node metastases and an intrapulmonary metastasis in the right lobe 2 years before. The patient received chemoradiotherapy which stabilized the metastases. The patient's medical comorbidities included left internal carotid artery stenosis, early colorectal cancer, early bladder cancer, hypertension, and hyperuricemia. The patient had no abdominal symptoms or physical examination findings, but follow-up PET-CT  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.  \nClin Case Rep. 2023;11:e8040 .  \n[https://doi.org/10.1002/ccr3.8040](https://doi.org/10.1002/ccr3.8040)  \n[wileyonlinelibrary.com/journal/ccr3](wileyonlinelibrary.com/journal/ccr3)  \n1 of 6  \n2 of 6  \n|  \nKANDA et al.  \nrevealed that18 F-fluorodeoxyglucose (FDG) had accumulated in the fundus of the gallbladder (Standard Uptake Value (SUV) max:4.2) and the hepatoduodenal lymph nodes (SUVmax:3.2), as well as in the mediastinum lymph nodes (right carina lymph node SUVmax:11.0, para-aorta lymph node SUVmax:6.1). A tumor in the gallbladder and those in the hepatoduodenal lymph nodes had diameters of 15 and 12 mm, respectively. No significant change was observed in lung tumor size (Figure","cbCaibHqpf8WtDaq","https://ap.wps.com/l/cbCaibHqpf8WtDaq","pdf",6475087,"English","# Introduction\n# Case history/ Examination\n# Differential diagnosis, Investigation, and Treatment","[{\"question\":\"What treatment was used for the patient’s gallbladder neuroendocrine carcinoma?\",\"answer\":\"The patient received nivolumab monotherapy (240 mg every 2 weeks), followed by surgery and adjuvant nivolumab.\"},{\"question\":\"How was the diagnosis clarified before treatment?\",\"answer\":\"Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of lymph nodes in the hepatoduodenal ligament identified small-cell neuroendocrine carcinoma, supporting primary gallbladder cancer with lymph node metastasis rather than lung adenocarcinoma metastasis.\"},{\"question\":\"What clinical and imaging changes occurred after nivolumab?\",\"answer\":\"After 10 courses, CT showed shrinkage of the gallbladder tumor with limited residual lymphadenopathy, and neuron-specific enolase (NSE) turned negative.\"}]","Effective treatment of gallbladder neuroendocrine carcinoma with nivolumab | PDF",1790267420,15]