Jin Hiroyuki, Ichisawa Aika, Hagiwara Yusuke, Hara Yutaro, Kimura Toshiro, Yonaiyama Shinnosuke, Yoshikawa Toru, Nakai Makoto, Tokura Tomohisa, Aoki Kazunori, Kawashima Hiroaki, Toyoki Yoshikazu, Endo Masaaki
Dept. of Surgery, Aomori City Hospital.
Gan To Kagaku Ryoho. 2020 Feb;47(2):364-366.
A 59-year-old man was diagnosed with cholecystolithiasis and cholecystitis and underwent cholecystectomy. The pathological findings were moderately differentiated adenocarcinoma(pT2)in the gallbladder fundus. Sixteen days after surgery, he visited our hospital due to jaundice. Abdominal enhanced CT and EOB-MRI revealed multiple liver metastases and lymph node metastases in the hepatoduodenal ligament that we deemed to be unresectable. A metallic stent was inserted for bile duct obstruction, and he underwent chemotherapy with gemcitabine plus cisplatin(GC). After 12 courses of GC, the metastatic lesions disappeared, and the patient showed complete response. FDG-PET/CT showed FDG uptake in the hepatoduodenal ligament and we subsequently decided to perform surgery. He underwent resection of the extrahepatic bile duct and regional lymphadenectomy. The pathological findings revealed no residual carcinomas in the bile duct or lymph nodes. We are continuing chemotherapy at present, and the patient is alive with no signs of recurrence at 1 year and 3 months following the diagnosis of multiple liver metastases.
