Liu Qin-Qin, Lin Hao-Ming, Han Hong-Wei, Yang Cai-Ni, Liu Chao, Zhang Rui
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation and Department of Biliary-Pancreatic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Front Oncol. 2022 Mar 14;12:803454. doi: 10.3389/fonc.2022.803454. eCollection 2022.
Gallbladder carcinosarcoma (GBCS) is a rare and aggressive malignancy with extremely poor prognosis. Although surgery is regarded as the primary therapy for GBCS, the effective therapeutic strategies for unresected lesions have been poorly defined.
We presented a case of a 74-year-old male who underwent radical resection of gallbladder carcinoma at a local hospital. Seven months later, he was admitted to our hospital due to right upper abdominal discomfort. Postoperative radiological examinations showed multiple hepatic lesions, hilar lymph node metastasis, and main portal vein tumor thrombus. The pathological consultation results confirmed GBCS and immunohistochemical examinations revealed PD-L1 expression in 20% of tumor cells. Then, the patient received chemotherapy (Gemcitabine plus Oxaliplatin, GEMOX) in combination with anti-PD-1 therapy. After nine courses of the combination therapy, complete regression of the tumors was achieved with no evidence of relapse till now.
We, for the first time, reported a patient with recurrent GBCS who benefited from the combined chemotherapy and immunotherapy, providing a potential effective management strategy for the refractory malignant tumor.
胆囊癌肉瘤（GBCS）是一种罕见且侵袭性强的恶性肿瘤，预后极差。尽管手术被视为GBCS的主要治疗方法，但对于未切除病变的有效治疗策略仍不明确。
我们报告了一例74岁男性患者，他在当地医院接受了胆囊癌根治性切除术。七个月后，因右上腹不适入住我院。术后影像学检查显示肝脏多发病变、肝门淋巴结转移及门静脉主干肿瘤血栓形成。病理会诊结果确诊为GBCS，免疫组化检查显示20%的肿瘤细胞表达PD-L1。随后，该患者接受了化疗（吉西他滨联合奥沙利铂，GEMOX）联合抗PD-1治疗。经过九个疗程的联合治疗，肿瘤完全消退，至今无复发迹象。
我们首次报道了一例复发性GBCS患者从化疗联合免疫治疗中获益，为难治性恶性肿瘤提供了一种潜在的有效管理策略。
