# Neuroendocrine carcinoma of the gallbladder

Source: https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/  
OnCo record `gallbladder-neuroendocrine-carcinoma` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Neuroendocrine carcinoma is a rare, fast-growing form of gallbladder cancer made of small cell or large cell hormone-type cells, often mixed with ordinary adenocarcinoma. It is usually advanced when found and median survival in the largest series was six to seven months. It is treated like other high-grade neuroendocrine carcinomas rather than like gallbladder adenocarcinoma.

## Summary

Gallbladder neuroendocrine carcinomas were characterised in 2026 from 31 cases among 636 gallbladder cancers: 7 pure small cell, 2 pure large cell and 22 mixed with an adenocarcinoma component (the neuroendocrine part averaging 80 percent of the tumour). The female to male ratio was 5.2 to 1 and median age 58, seven years younger than ordinary gallbladder cancer; high-grade glandular dysplasia was present in 15, six arising in intracholecystic papillary neoplasms. Median Ki-67 was 70 percent, lymphovascular invasion was seen in 74 percent and perineural invasion in 56 percent; 72 percent were pT3 or pT4 against 26 percent of ordinary cancers. Synaptophysin was positive in 95 percent, chromogranin in 75 percent and CD56 in 90 percent; the pRB/p16 pathway was inactivated in 83 percent and p53 was mutant-pattern in 89 percent. Median survival was 6.1 months, with a few unexpectedly long survivors (Reid 2026). In SEER (287 cases, 1975 to 2016) the incidence was 1.6 percent of gallbladder carcinomas, the male to female ratio 1 to 2, median survival 7 months, and one, two, three and five-year overall survival 36.6, 17.8, 13.2 and 7.3 percent; serum chromogranin A was proposed as a marker (Cai 2022). Cancer Research UK lists small cell (oat cell) carcinoma and neuroendocrine tumours among the rare types and notes they are not necessarily treated like adenocarcinoma.

What differs in treatment: these are managed as poorly differentiated neuroendocrine carcinomas of the digestive tract, with platinum and etoposide chemotherapy rather than gemcitabine and cisplatin, and surgery for the minority with localised disease; a population-based analysis found surgery and adjuvant chemotherapy each associated with better survival (Khan 2023, J Pers Med, doi 10.3390/jpm13061009). Mixed tumours are treated according to the higher-grade neuroendocrine component. Well-differentiated neuroendocrine tumours of the gallbladder are a separate, far less aggressive group covered on the neuroendocrine pages.

## Fields

- Kind: Cancer
- Last checked: 2026-09-24
- Also known as: Small cell carcinoma of the gallbladder; Oat cell carcinoma of the gallbladder; Large cell neuroendocrine carcinoma of the gallbladder; Mixed neuroendocrine non-neuroendocrine neoplasm of the gallbladder; MiNEN
- Tags: gallbladder; biliary; subtype-page
- Group: gastrointestinal
- Burden: Under 5 percent of gallbladder cancers in a 636-case pathology cohort (Reid 2026), 1.6 percent of gallbladder carcinomas in SEER (Cai 2022) and 3.3 percent of gallbladder neoplasms in the US National Cancer Database 2011 to 2020 (Louis 2025).
- Subtypes: Small cell neuroendocrine carcinoma of the gallbladder; Large cell neuroendocrine carcinoma of the gallbladder; Mixed neuroendocrine and non-neuroendocrine neoplasm of the gallbladder (adenocarcinoma plus neuroendocrine carcinoma); Well-differentiated neuroendocrine tumour of the gallbladder (separate, low grade)
- Biomarkers: Synaptophysin, chromogranin A and CD56 on immunohistochemistry; Ki-67 proliferation index (median 70 percent); Loss of pRB or p16 and mutant-pattern p53; Serum chromogranin A (proposed); Share of neuroendocrine versus adenocarcinoma component

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/gallbladder-neuroendocrine-carcinoma/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/#overview
- Types and stages (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/#what-it-is [4 subtypes]
- Symptoms and diagnosis (on the hub): How this cancer shows itself, how the diagnosis is confirmed, and the biomarkers clinicians test for. https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/#finding-it [5 biomarkers]
- Treatment (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/#treating-it [2 settings]
- Trials and papers (on the hub): Trials recruiting now, the landmark trials, the trials held by this cancer's subtypes, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/#evidence
- Biology and targets (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/#science
- Countries and centres (own page): Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes. https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/where-you-are/
- Decisions and support (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/#living-with-it [9 questions, 3 red cards]
- Pipeline and open problems (own page): Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/coming/ [1 medicine]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/gallbladder-neuroendocrine-carcinoma/data/ [8 connected records]

## Standard of care

- Localised disease: Resection as for gallbladder cancer where feasible; surgery and adjuvant chemotherapy were each associated with better survival in population data. ([Radical (extended) cholecystectomy](https://onco.cc/terms/radical-cholecystectomy/), [Extrapulmonary neuroendocrine carcinoma](https://onco.cc/cancers/extrapulmonary-nec/))
- Advanced disease: Platinum and etoposide chemotherapy as for other extrapulmonary neuroendocrine carcinomas, rather than the gemcitabine and cisplatin used for adenocarcinoma. ([Extrapulmonary neuroendocrine carcinoma](https://onco.cc/cancers/extrapulmonary-nec/), [Cisplatin](https://onco.cc/drugs/cisplatin/), [Grade 3 well-differentiated neuroendocrine tumour](https://onco.cc/cancers/grade-3-net/))

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Neuroendocrine_tumor
- Reid, Am J Surg Pathol 2026: neuroendocrine carcinoma of the gallbladder, 31 cases: https://doi.org/10.1097/pas.0000000000002580
- Cai and Wu, World J Clin Cases 2022: gallbladder neuroendocrine carcinoma in SEER: https://doi.org/10.12998/wjcc.v10.i23.8212
- Louis, Cancer Causes Control 2025: gallbladder adenocarcinoma and neuroendocrine carcinoma in the National Cancer Database: https://doi.org/10.1007/s10552-025-01967-8
- CRUK: types of gallbladder cancer: https://www.cancerresearchuk.org/about-cancer/gallbladder-cancer/types
- Khan, J Pers Med 2023: surgery and adjuvant chemotherapy in gallbladder neuroendocrine carcinoma: https://doi.org/10.3390/jpm13061009

## Connected records

- cancers: [Adenosquamous and squamous carcinoma of the gallbladder](https://onco.cc/cancers/gallbladder-adenosquamous-squamous-carcinoma/), [Extrapulmonary neuroendocrine carcinoma](https://onco.cc/cancers/extrapulmonary-nec/), [Gallbladder adenocarcinoma](https://onco.cc/cancers/gallbladder-adenocarcinoma/), [Gallbladder cancer](https://onco.cc/cancers/gallbladder/), [Grade 3 well-differentiated neuroendocrine tumour](https://onco.cc/cancers/grade-3-net/), [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/)
- terms: [Grade](https://onco.cc/terms/tumour-grade/), [Lymphovascular invasion (LVI)](https://onco.cc/terms/lymphovascular-invasion/), [Perineural invasion (PNI)](https://onco.cc/terms/perineural-invasion/), [Radical (extended) cholecystectomy](https://onco.cc/terms/radical-cholecystectomy/)
- drugs: [Cisplatin](https://onco.cc/drugs/cisplatin/)

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JSON: https://onco.cc/api/v1/entities/gallbladder-neuroendocrine-carcinoma.json