Successful radical surgical resection of initially unresectable intrahepatic cholangiocarcinoma by downsizing chemotherapy with gemcitabine plus cisplatin: a case report
Abstract Background Intrahepatic cholangiocarcinoma (ICC) is a subtype of biliary tract cancer (BTC). Recently, downsizing chemotherapy has been applied to initially unresectable BTCs, including ICC. Case presentation We report a case of liver resection in a 23-year-old woman who was diagnosed with...
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Japan Surgical Society
2017-11-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-017-0395-y |
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| author | Ryosuke Takayanagi Shigetsugu Takano Kensuke Sugiura Hideyuki Yoshitomi Katsunori Furukawa Tsukasa Takayashiki Satoshi Kuboki Atsushi Kato Masaru Miyazaki Masayuki Ohtsuka |
| author_facet | Ryosuke Takayanagi Shigetsugu Takano Kensuke Sugiura Hideyuki Yoshitomi Katsunori Furukawa Tsukasa Takayashiki Satoshi Kuboki Atsushi Kato Masaru Miyazaki Masayuki Ohtsuka |
| author_sort | Ryosuke Takayanagi |
| collection | DOAJ |
| description | Abstract Background Intrahepatic cholangiocarcinoma (ICC) is a subtype of biliary tract cancer (BTC). Recently, downsizing chemotherapy has been applied to initially unresectable BTCs, including ICC. Case presentation We report a case of liver resection in a 23-year-old woman who was diagnosed with initially unresectable ICC attached to the inferior vena cava, with portal vein (PV) cavernous transformation. Positron emission tomography (PET) showed fluorodeoxyglucose (FDG) uptake in the para-aortic lymph nodes. Upon using downsizing chemotherapy (the combination of gemcitabine [GEM] and cisplatin [CDDP]), the size of tumor reduced by 55% and FDG uptake in the para-aortic lymph node metastases disappeared. A right hemihepatectomy was performed, along with dissection of lymph nodes, including the para-aortic lymph nodes. The PV cavernous transformation was preserved to maintain collateral flow as much as possible, as it was considered to originate from a congenital anomaly. Pathological examination revealed that R0 resection was performed and that there were no viable neoplastic cells remaining in the para-aortic lymph nodes. The patient is alive at 31 months after initial treatment, with a local recurrence. Conclusion Downsizing chemotherapy with GEM plus CDDP followed by radical surgical resection is an attractive treatment for initially unresectable BTC. |
| format | Article |
| id | doaj-art-5b4b7db44aee4aa394bd2ebc264b847d |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2017-11-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-5b4b7db44aee4aa394bd2ebc264b847d2025-08-20T02:53:17ZengJapan Surgical SocietySurgical Case Reports2198-77932017-11-01311510.1186/s40792-017-0395-ySuccessful radical surgical resection of initially unresectable intrahepatic cholangiocarcinoma by downsizing chemotherapy with gemcitabine plus cisplatin: a case reportRyosuke Takayanagi0Shigetsugu Takano1Kensuke Sugiura2Hideyuki Yoshitomi3Katsunori Furukawa4Tsukasa Takayashiki5Satoshi Kuboki6Atsushi Kato7Masaru Miyazaki8Masayuki Ohtsuka9Department of General Surgery, Chiba University Graduate School of MedicineDepartment of General Surgery, Chiba University Graduate School of MedicineDepartment of General Surgery, Chiba University Graduate School of MedicineDepartment of General Surgery, Chiba University Graduate School of MedicineDepartment of General Surgery, Chiba University Graduate School of MedicineDepartment of General Surgery, Chiba University Graduate School of MedicineDepartment of General Surgery, Chiba University Graduate School of MedicineDepartment of Gastroenterological Surgery, Mita Hospital, International University of Health and WelfareDepartment of General Surgery, Chiba University Graduate School of MedicineDepartment of General Surgery, Chiba University Graduate School of MedicineAbstract Background Intrahepatic cholangiocarcinoma (ICC) is a subtype of biliary tract cancer (BTC). Recently, downsizing chemotherapy has been applied to initially unresectable BTCs, including ICC. Case presentation We report a case of liver resection in a 23-year-old woman who was diagnosed with initially unresectable ICC attached to the inferior vena cava, with portal vein (PV) cavernous transformation. Positron emission tomography (PET) showed fluorodeoxyglucose (FDG) uptake in the para-aortic lymph nodes. Upon using downsizing chemotherapy (the combination of gemcitabine [GEM] and cisplatin [CDDP]), the size of tumor reduced by 55% and FDG uptake in the para-aortic lymph node metastases disappeared. A right hemihepatectomy was performed, along with dissection of lymph nodes, including the para-aortic lymph nodes. The PV cavernous transformation was preserved to maintain collateral flow as much as possible, as it was considered to originate from a congenital anomaly. Pathological examination revealed that R0 resection was performed and that there were no viable neoplastic cells remaining in the para-aortic lymph nodes. The patient is alive at 31 months after initial treatment, with a local recurrence. Conclusion Downsizing chemotherapy with GEM plus CDDP followed by radical surgical resection is an attractive treatment for initially unresectable BTC.http://link.springer.com/article/10.1186/s40792-017-0395-yIntrahepatic cholangiocarcinoma (ICC)Biliary tract cancer (BTC)Initially unresectable BTCDownsizing chemotherapyConversion surgery |
| spellingShingle | Ryosuke Takayanagi Shigetsugu Takano Kensuke Sugiura Hideyuki Yoshitomi Katsunori Furukawa Tsukasa Takayashiki Satoshi Kuboki Atsushi Kato Masaru Miyazaki Masayuki Ohtsuka Successful radical surgical resection of initially unresectable intrahepatic cholangiocarcinoma by downsizing chemotherapy with gemcitabine plus cisplatin: a case report Surgical Case Reports Intrahepatic cholangiocarcinoma (ICC) Biliary tract cancer (BTC) Initially unresectable BTC Downsizing chemotherapy Conversion surgery |
| title | Successful radical surgical resection of initially unresectable intrahepatic cholangiocarcinoma by downsizing chemotherapy with gemcitabine plus cisplatin: a case report |
| title_full | Successful radical surgical resection of initially unresectable intrahepatic cholangiocarcinoma by downsizing chemotherapy with gemcitabine plus cisplatin: a case report |
| title_fullStr | Successful radical surgical resection of initially unresectable intrahepatic cholangiocarcinoma by downsizing chemotherapy with gemcitabine plus cisplatin: a case report |
| title_full_unstemmed | Successful radical surgical resection of initially unresectable intrahepatic cholangiocarcinoma by downsizing chemotherapy with gemcitabine plus cisplatin: a case report |
| title_short | Successful radical surgical resection of initially unresectable intrahepatic cholangiocarcinoma by downsizing chemotherapy with gemcitabine plus cisplatin: a case report |
| title_sort | successful radical surgical resection of initially unresectable intrahepatic cholangiocarcinoma by downsizing chemotherapy with gemcitabine plus cisplatin a case report |
| topic | Intrahepatic cholangiocarcinoma (ICC) Biliary tract cancer (BTC) Initially unresectable BTC Downsizing chemotherapy Conversion surgery |
| url | http://link.springer.com/article/10.1186/s40792-017-0395-y |
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