Successful radical surgical resection of initially unresectable intrahepatic cholangiocarcinoma by downsizing chemotherapy with gemcitabine plus cisplatin: a case report

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...

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Bibliographic Details
Published in:Surgical case reports 2017-11, Vol.3 (1), p.116-116, Article 116
Main Authors: Takayanagi, Ryosuke, Takano, Shigetsugu, Sugiura, Kensuke, Yoshitomi, Hideyuki, Furukawa, Katsunori, Takayashiki, Tsukasa, Kuboki, Satoshi, Kato, Atsushi, Miyazaki, Masaru, Ohtsuka, Masayuki
Format: Article
Language:English
Subjects:
Biliary tract cancer (BTC)
Case Report
Conversion surgery
Downsizing chemotherapy
Initially unresectable BTC
Intrahepatic cholangiocarcinoma (ICC)
Medicine
Medicine & Public Health
Surgery
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Summary: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.
ISSN:2198-7793
2198-7793
DOI:10.1186/s40792-017-0395-y