Department of General Surgery, Kitakyushu General Hospital.
Department of Emergency, Kitakyushu General Hospital.
J UOEH. 2022;44(3):277-286. doi: 10.7888/juoeh.44.277.
Although surgical resection is the only available treatment to achieve long-term survival in biliary tract cancer, many cases are often identified at an advanced stage at the time of diagnosis. Radiotherapy may be an alternative option to prolong survival in cases with locally advanced unresectable disease. While there are some reports of long-term survival after radiotherapy for unresectable biliary tract cancer, it is rare that clinical symptoms are exhibited by peritoneal dissemination more than 8 years after radiotherapy and that resection can be performed. Our case was a 55-year-old female who had visited with a complaint of jaundice and was diagnosed with primary unresectable hilar cholangiocarcinoma. She received definitve chemoradiotherapy, and repeated receiving maintenance chemotherapy thereafter until clinical manifestation. During follow-up, she was diagnosed with stenosis of the sigmoid colon, which was attributed to peritoneal dissemination of cholangiocarcinoma. We herein report a rare case of primary unresectable hilar cholangiocarcinoma after chemoradiotherapy which was followed by chemotherapy that was controlled for more than 8 years but eventually caused colonic obstruction attributed to peritoneal dissemination.
尽管手术切除是唯一可实现胆道癌长期生存的治疗方法，但许多病例在诊断时通常已处于晚期。对于局部晚期不可切除的疾病，放射治疗可能是延长生存的一种替代选择。虽然有一些关于不可切除的胆道癌放射治疗后长期生存的报道，但放射治疗 8 年后出现腹膜播散并能进行切除的临床症状非常罕见。我们的病例是一名 55 岁女性，因黄疸就诊，被诊断为原发性不可切除的肝门部胆管癌。她接受了根治性放化疗，此后反复接受维持化疗，直到出现临床表现。在随访过程中，她被诊断为乙状结肠狭窄，这归因于胆管癌的腹膜播散。我们在此报告一例罕见的原发性不可切除的肝门部胆管癌病例，该患者在接受放化疗后进行了化疗，控制了 8 年以上，但最终因腹膜播散导致结肠梗阻。
