Hong Ye, Li Xiaofen, Cao Dan
Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Front Oncol. 2021 Feb 25;11:538328. doi: 10.3389/fonc.2021.538328. eCollection 2021.
Extrahepatic cholangiocarcinoma (ECC) is an uncommon and devastating malignancy that mainly consists of adenocarcinoma. Adenosquamous carcinoma is a rare histologic type and accounts for 2-5% of ECC. It reports that 3.6-8.5% of ECC patients carry Her-2 amplification. A 45-year-old woman was admitted to our hospital because of jaundice. Abdominal computerized tomography (CT) suggested extrahepatic biliary tract mass. The patient received surgery and pathological examination confirmed adenosquamous carcinoma. Fluorescence in Situ Hybridization (FISH) and Next-generation sequencing showed the tumor had Her-2 amplification. One month after the operation, CT demonstrated distant lymph nodes metastases (cT3N1M1, stage IV). The patient received gemcitabine and cisplatin combined with targeted therapy of trastuzumab. After three cycles of treatment, the evaluation of response was stable disease (SD). The progression-free survival of 1st line treatment (PFS1) reached 5 months with five cycles of treatment. After progression, the patient received three cycles of albumin-bound paclitaxel combined with S-1 and trastuzumab and concurrent chemoradiotherapy (S-1) because of serious backache. Now, the disease is stable, and the PFS of 2nd line treatment (PFS2) has reached 7 months.
肝外胆管癌（ECC）是一种罕见且具有毁灭性的恶性肿瘤，主要由腺癌组成。腺鳞癌是一种罕见的组织学类型，占ECC的2%-5%。据报道，3.6%-8.5%的ECC患者存在Her-2扩增。一名45岁女性因黄疸入院。腹部计算机断层扫描（CT）提示肝外胆道肿物。患者接受手术，病理检查确诊为腺鳞癌。荧光原位杂交（FISH）和二代测序显示肿瘤存在Her-2扩增。术后1个月，CT显示远处淋巴结转移（cT3N1M1，IV期）。患者接受吉西他滨和顺铂联合曲妥珠单抗靶向治疗。经过三个周期的治疗，疗效评估为疾病稳定（SD）。一线治疗的无进展生存期（PFS1）在五个周期的治疗后达到5个月。疾病进展后，患者因严重背痛接受了三个周期的白蛋白结合型紫杉醇联合S-1及曲妥珠单抗治疗，并同步进行了化疗放疗（S-1）。目前，疾病稳定，二线治疗的无进展生存期（PFS2）已达到7个月。
