Shiozaki Shigehiro, Satoh Daisuke, Matsukawa Hiroyoshi, Yamaguchi Kenji, Takahashi Kazutaka, Mimura Naoki, Taguchi Kazuhiro, Araki Hiroyuki, Toshima Toshiaki, Kato Takuya, Miyake Soichiro, Miyoshi Hisanobu, Yoshida Kazuhiro, Choda Yasuhiro, Tokumoto Noriaki, Kanazawa Takashi, Harano Masao, Ojima Yasutomo, Idani Hitoshi, Okajima Masazumi, Ninomiya Motoki
Dept. of Surgery, Hiroshima City Hiroshima Citizens Hospital.
Gan To Kagaku Ryoho. 2014 Nov;41(12):2089-91.
A 72-year-old woman was diagnosed with liver dysfunction during a medical examination. An abdominal computed tomography (CT) scan showed multiple nodules in the left lobe, anterior segment, andposterior segment of the liver, leading to a diagnosis of intrahepatic cholangiocarcinoma (ICC). Extended left lobectomy and partial hepatectomy in the anterior and posterior segment with lymph node dissection was performed. At the time of the operation, small nodules on the peritoneum near the stomach were resected; these nodules were diagnosed as peritoneal disseminations of ICC. The histopathological diagnosis was moderately differentiated tubular adenocarcinoma (T4N0M1, Stage IVB). Adjuvant chemotherapy with S-1 was administered for 18 months. Thirty months after the operation, multiple lung metastases were detected by using CT, and chemotherapy with gemcitabine was initiated. Thirty-six months after chemotherapy with gemcitabine, the patient is alive and at home despite her lung metastases, which grew slightly in size. Herein, we report a long-term survival case of ICC with peritoneal dissemination that was successfully treated with surgical resection and adjuvant chemotherapy.
一名72岁女性在体检时被诊断为肝功能不全。腹部计算机断层扫描(CT)显示肝脏左叶、前段和后段有多个结节,诊断为肝内胆管癌(ICC)。实施了扩大左叶切除术以及肝前段和后段部分肝切除术并进行淋巴结清扫。手术时,切除了胃附近腹膜上的小结节;这些结节被诊断为ICC的腹膜播散。组织病理学诊断为中分化管状腺癌(T4N0M1,IVB期)。给予S-1辅助化疗18个月。术后30个月,通过CT检测到多处肺转移,遂开始使用吉西他滨进行化疗。使用吉西他滨化疗36个月后,尽管患者有肺转移且转移灶大小略有增大,但仍存活并在家中。在此,我们报告一例经手术切除和辅助化疗成功治疗的伴有腹膜播散的ICC长期生存病例。