[A Case with Three Resections of the Pulmonary Metastases of a Distal Bile Duct Carcinoma].

Abstract

A 68-year-old man underwent a subtotal stomach-preserving pancreatoduodenectomy(SSPPD)for a distal bile duct carcinoma(BDC)pT3aN1M0, pStage ⅡB and adjuvant chemotherapy with gemcitabine. One year 7 months after the initial surgery, CT revealed a nodule with an increasing tendency in the left lung. As it was difficult to distinguish primary lung cancer from BDC lung metastasis, we performed a thoracoscopic left wedge resection. The histopathology of the resected specimen was BDC lung metastasis. In the follow-up with adjuvant chemotherapy with S-1 for 10 months, 2 nodules were found in the right lung, and we performed thoracoscopic right S6 segmentectomy. Eight months later, another nodule was found in the left lung, and we performed thoracoscopic left wedge resection. The histopathology was BDC lung metastasis for all the resected specimens. The patient is alive with no evidence of recurrence after 9 months of the latest surgery(4 years 11 months after the initial surgery). Although the standard treatment for metastatic recurrence of BDC is systemic chemotherapy, some cases treated with surgical resection had relatively good prognosis, such as the present case. Surgical resection might be feasible as a treatment option for metastatic recurrence of BDC.

• Authors: Koshiro Ando, Yoshito Tomimaru, Takashi Iwazawa, Kozo Noguchi, Hirotsugu Nagase, Takayuki Ogino, Masashi Hirota, Kazuteru Oshima, Tsukasa Tanida, Shingo Noura, Tomono Kawase, Hiroshi Imamura, Kenzo Akagi, Keizo Dono
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 46 Issue 13 Pg. 2369-2371 (Dec 2019) ISSN: 0385-0684 [Print] Japan
• PMID: 32156934 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Drug Combinations
• S 1 (combination)
• Tegafur
• Oxonic Acid

Topics

• Aged
• Antimetabolites, Antineoplastic (therapeutic use)
• Bile Duct Neoplasms (drug therapy, surgery)
• Bile Ducts
• Drug Combinations
• Humans
• Lung Neoplasms (drug therapy, secondary, surgery)
• Male
• Neoplasm Recurrence, Local
• Oxonic Acid (therapeutic use)
• Pancreaticoduodenectomy
• Pneumonectomy
• Tegafur (therapeutic use)