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Complete resolution of advanced carcinoma of the gallbladder: Report of a case
Author(s) -
Miura Kazuo,
Matsumoto Yoshiro,
Nagahori Kaoru,
Akahane Yoshihiro,
Fujino Masayuki A.,
Suda Koichi,
Araki Tsutomu
Publication year - 1993
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf01235931
Subject(s) - hepatoduodenal ligament , paraaortic lymph nodes , medicine , carcinoembryonic antigen , carcinoma , cholecystectomy , gallbladder , lymph node , pathology , common hepatic artery , metastasis , mitomycin c , pancreaticoduodenectomy , radiology , gastroenterology , surgery , pancreas , cancer , artery , resection
A primary carcinoma of the gallbladder with a massive invasion to the liver and a metastasis to the retropancreatic (head) lymph node developed in a 56‐year‐old female. Serum levels of carbohydrate antigen 19‐9 and carcinoembryonic antigen were 106U/ml and 8.9 ng/ml, respectively. 5‐Fluorouracil (500mg), mitomycin C (10mg), and adriamycin (30 mg), were administered systemically; on the 4th day after the first administration a single‐shot infusion of mitomycin C (20mg) was given via the proper hepatic artery. This was done 5 weeks before surgery, since there were far‐advanced extensions (T4) of the tumor. However, no response to the chemotheraphy was seen on computed tomography. Curative resection of the tumor was performed by pancreaticoduodenectomy, with dissection of the lymph nodes in the hepatoduodenal ligament and the paraaortic region, and by anterior segmentectomy of the liver. Pathology of the surgical specimens showed tumor necrosis. Microscopic examination revealed no viable cells in either the primary tumor or the metastatic node, and reticulin staining identified the necrosis as an epithelial structure. This case represents the histological confirmation of complete resolution of advanced carcinoma of the gallbladder by chemotherapy.