[A case of unresectable advanced cancer of the gall bladder successfully treated by arterial infusion therapy with cisplatin].
A 70-year-old male was admitted for obstructive jaundice. He was diagnosed as an unresectable advanced cancer of the gall bladder that was stage IV associated with direct extension of the liver (Hinf3) and the bile duct (Binf3), and with enlargement of paraaortic lymph node (N4(+)) by image analyses. Intraarterial infusion therapy with cisplatin (CDDP, 50 mg) was started through the common hepatic artery. Since the primary tumor and the enlarged paraaortic lymph node shrank markedly and the bile duct was completely obstructed, additional arterial infusion with CDDP (50 mg) was made. CT examination thereafter revealed that the paraaortic lymph node enlargement disappeared although thickening of the gall bladder wall still remained. Therefore this case was considered as a complete response (CR). Then, a reservoir for hepatic arterial infusion was implanted and CDDP (a total of 230 mg) was repeatedly infused 5 times. CT scanning images taken 7 months after the start of the treatment showed neither primary tumor nor enlargement of paraaortic lymph node. An extensive cholecystectomy was performed. Histopathological examination revealed signet-ring cell carcinoma located in all layers of the gall bladder. Factors indicating clinicopathological stage were se, hinf1, vs0, bw1, hw0 and ew2 (according to the General Rules for Surgical and Pathological Studies on Cancer of Bile duct).
Shikata
A
A
Dept. of Surgery, Shimizu Municipal Hospital.
Mori
K
K
Watahiki
Y
Y
Ohara
M
M
Yamazaki
M
M
Hoshiya
Y
Y
Kosaka
A
A
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001650:Bile Duct Neoplasms / Q000473:pathology; D018279:Carcinoma, Signet Ring Cell / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage*; D005706:Gallbladder Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006499:Hepatic Artery; D006801:Humans; D015918:Infusion Pumps, Implantable; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000473:pathology; D008297:Male; D009361:Neoplasm Invasiveness
D000970:Antineoplastic Agents; D002945:Cisplatin