内容紹介
A Case of Disease-Free, Long Survival in a Patient with Mixed Adenoneuroendocrine Carcinoma of the Gallbladder Treated with Induction CDDP/CPT-11 Chemotherapy and Resection
Summary
A 57-year-old woman with a complaint of a right upper quadrant mass was referred to our hospital. Multimodal studies such as PET-CT revealed large hepatic tumors and swollen para-aortic lymph nodes, the origin of which was unclear. Pathological analysis of a biopsy specimen obtained from the liver tumor led to a diagnosis of neuroendocrine carcinoma. After 4 CDDP/CPT-11 chemotherapy treatment courses, remarkable shrinkage of liver tumors and disappearance of the swollen lymph nodes were achieved. Subsequently, liver tumor and extrahepatic bile duct resection and lymphatic dissection were performed. Pathological analysis of the resected specimens revealed that the liver tumors and metastatic lymph nodes originated from the gallbladder, leading to a diagnosis of mixed adenoneuroendocrine carcinoma. After 5 courses of adjuvant chemotherapy using the same regimen, the patient has remained disease free for 24 months since the initial diagnosis.
要旨
50歳台,女性。右季肋部のしこりを主訴に近医受診し,多発性肝腫瘍を認めたため当院紹介。PET-CTなどの画像検査で傍大動脈リンパ節転移も認めたが原発不明,肝腫瘍生検にて神経内分泌癌と診断した。化学療法CDDP/CPT-11により両病変とも著明な縮小が得られ,肝切除術を施行した。病理結果は胆嚢原発の混合型腺神経内分泌癌(MANEC)であった。術後補助化学療法として同レジメンを追加し,診断から2年経過した現時点で無再発生存中である。胆嚢MANECは極めてまれで予後不良な疾患であるが,本例は化学療法によって手術が可能となり臨床的治癒が得られた貴重な症例である。
目次
Summary
A 57-year-old woman with a complaint of a right upper quadrant mass was referred to our hospital. Multimodal studies such as PET-CT revealed large hepatic tumors and swollen para-aortic lymph nodes, the origin of which was unclear. Pathological analysis of a biopsy specimen obtained from the liver tumor led to a diagnosis of neuroendocrine carcinoma. After 4 CDDP/CPT-11 chemotherapy treatment courses, remarkable shrinkage of liver tumors and disappearance of the swollen lymph nodes were achieved. Subsequently, liver tumor and extrahepatic bile duct resection and lymphatic dissection were performed. Pathological analysis of the resected specimens revealed that the liver tumors and metastatic lymph nodes originated from the gallbladder, leading to a diagnosis of mixed adenoneuroendocrine carcinoma. After 5 courses of adjuvant chemotherapy using the same regimen, the patient has remained disease free for 24 months since the initial diagnosis.
要旨
50歳台,女性。右季肋部のしこりを主訴に近医受診し,多発性肝腫瘍を認めたため当院紹介。PET-CTなどの画像検査で傍大動脈リンパ節転移も認めたが原発不明,肝腫瘍生検にて神経内分泌癌と診断した。化学療法CDDP/CPT-11により両病変とも著明な縮小が得られ,肝切除術を施行した。病理結果は胆嚢原発の混合型腺神経内分泌癌(MANEC)であった。術後補助化学療法として同レジメンを追加し,診断から2年経過した現時点で無再発生存中である。胆嚢MANECは極めてまれで予後不良な疾患であるが,本例は化学療法によって手術が可能となり臨床的治癒が得られた貴重な症例である。