Tani Satoshi, Yamagishi Sari, Fukunaga Kaoru, Morita Munetaka, Sonoda Takashi, Murao Shinichi, Ikuta Shinichi, Kakuno Ayako, Yamanaka Naoki
Dept. of Internal Medicine, Kohnan Hospital.
Gan To Kagaku Ryoho. 2015 Jan;42(1):113-7.
A 57-year-old woman with a complaint of a right upper quadrant mass was referred to our hospital. Multimodal studies such as PET-CT revealed large hepatic tumors and swollen para-aortic lymph nodes, the origin of which was unclear. Pathological analysis of a biopsy specimen obtained from the liver tumor led to a diagnosis of neuroendocrine carcinoma. After 4 CDDP/CPT-11 chemotherapy treatment courses, remarkable shrinkage of liver tumors and disappearance of the swollen lymph nodes were achieved. Subsequently, liver tumor and extrahepatic bile duct resection and lymphatic dissection were performed. Pathological analysis of the resected specimens revealed that the liver tumors and metastatic lymph nodes originated from the gallbladder, leading to a diagnosis of mixed adenoneuroendocrine carcinoma. After 5 courses of adjuvant chemotherapy using the same regimen, the patient has remained disease free for 24 months since the initialdiagnosis.
一名57岁女性因右上腹肿物前来我院就诊。PET-CT等多模态检查发现肝脏有巨大肿瘤,腹主动脉旁淋巴结肿大,但其起源不明。对肝脏肿瘤活检标本进行病理分析后诊断为神经内分泌癌。经过4个周期的顺铂/伊立替康化疗,肝脏肿瘤明显缩小,肿大淋巴结消失。随后进行了肝肿瘤及肝外胆管切除和淋巴结清扫术。对切除标本的病理分析显示,肝脏肿瘤和转移淋巴结起源于胆囊,诊断为混合性腺神经内分泌癌。采用相同方案进行5个周期的辅助化疗后,自初次诊断以来,患者已无病生存24个月。