Successful Treatment of Intrahepatic Cholangiocarcinoma With Liver/Lung Metastasis and Peritoneal Dissemination After Liver Resection
Successful Treatment of Intrahepatic Cholangiocarcinoma With Liver/Lung Metastasis and Peritoneal Dissemination After Liver Resection
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DOI：
10.21873/anticanres.15811
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发表时间：
2022-05
影响因子：
2
通讯作者：
Kazuki Matsumura;K. Yamamura;Eri Oda;S. Akahoshi;T. Ishiko;T. Miyata;H. Miyamoto;T. Motohara;A. Sasao;Y. Komohara;H. Kawano;T. Beppu
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文献类型：
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作者：
Kazuki Matsumura;K. Yamamura;Eri Oda;S. Akahoshi;T. Ishiko;T. Miyata;H. Miyamoto;T. Motohara;A. Sasao;Y. Komohara;H. Kawano;T. Beppu
背景/目的：肝内胆管细胞癌（ICC）的发病率正在增加，预后不良。病例报告：一位79岁的女性有两个肝脏肿瘤被提到我们的机构。肿瘤边缘不规则，周边连续强化。她的肝功能良好，CA 19 -9水平升高。行扩大左肝切除术和部分肝切除术。患者被诊断为低分化ICC。两个肺转移，一个肝转移，和局限性腹膜内传播发生在首次肝切除术后19，24和32个月。大约在观察一年后，用计算机断层扫描引导的射频消融术治疗肺转移瘤。肝转移瘤立即切除。使用吉西他滨和S-1进行有效的3个月化疗后，腹膜播散被完全清除。患者在第一次手术后44个月存活，无肿瘤。结论：考虑到转移部位和肿瘤恶性程度的多学科治疗可能对多次复发的ICC患者有效。
Background/Aim: Intrahepatic cholangiocarcinoma (ICC) is increasing in incidence and has a poor prognosis. Case Report: A 79-year-old woman with two liver tumors was referred to our institution. The tumors demonstrated irregular margins and continuous peripheral enhancement. She had a good liver function and an elevated CA19-9 level. Extended left hepatectomy, and partial hepatectomy was performed. The patient was diagnosed with poorly differentiated ICC. Two lung metastases, one liver metastasis, and localized intraperitoneal dissemination occurred 19, 24, and 32 months after the initial hepatectomy. The lung metastases were treated with computed tomography-guided radiofrequency ablation approximately after one year of observation. The liver metastasis was resected immediately. The peritoneal dissemination was removed entirely after effective 3-month chemotherapy using gemcitabine and S-1. The patient is alive with no tumor 44 months after the first surgery. Conclusion: Multidisciplinary treatment considering a metastatic site and tumor malignancy might be effective for patients with ICC who have multiple recurrences.