Gut Liver.  2013 May;7(3):371-376. 10.5009/gnl.2013.7.3.371.

A Case of Common Bile Duct Cancer That Completely Responded to Combination Chemotherapy of Gemcitabine and TS-1

• Lim JH
• Ryu JK
• Choi YJ
• Kwon J
• Kim JY
• Lee YB
• Kim JH
• Yoon WJ
• Kim YT
• Yoon YB

• KMID: 1431357
• DOI: http://doi.org/10.5009/gnl.2013.7.3.371

Abstract

Common bile duct (CBD) cancer is a relatively rare malignancy that arises from the biliary epithelium and is associated with a poor prognosis. Here, we report a case of advanced metastatic CBD cancer successfully treated by chemotherapy with gemcitabine combined with S-1 (tegafur+gimeracil+oteracil). A 65-year-old male presented with pyogenic liver abscess. After antibiotic therapy and percutaneous drainage, follow-up computed tomography (CT) showed an enhanced nodule in the CBD. Biopsy was performed at the CBD via endoscopic retrograde cholangiopancreatography, which showed adenocarcinoma. Additional CT and magnetic resonance imaging showed multiple small nodules in the right hepatic lobe, which were confirmed as metastatic adenocarcinoma by sono-guided liver biopsy. The patient underwent combination chemotherapy with gemcitabine and S-1. After nine courses of chemotherapy, the hepatic lesion disappeared radiologically. Pylorus-preserving pancreaticoduodenectomy was performed, and no residual tumor was found in the resected specimen. Three weeks after the operation, the patient was discharged with no complications. Through 3 months of follow-up, no sign of recurrence was observed on CT scan. Gemcitabine combined with S-1 may be a highly effective treatment for advanced cholangiocarcinoma.

Keyword

Cholangiocarcinoma; Gemcitabine; S-1

MeSH Terms

Adenocarcinoma
Biopsy
Cholangiocarcinoma
Cholangiopancreatography, Endoscopic Retrograde
Common Bile Duct
Deoxycytidine
Drainage
Drug Therapy, Combination
Epithelium
Follow-Up Studies
Humans
Liver
Liver Abscess, Pyogenic
Magnetic Resonance Imaging
Male
Neoplasm, Residual
Pancreaticoduodenectomy
Prognosis
Recurrence
Silicates
Titanium
Deoxycytidine
Silicates
Titanium