title: [A 42-month disease free survival case of combined hepatocellular-cholangiocarcinoma with lymph node metastases treated with multimodal therapy].
abstract: Combined hepatocellular and cholangiocarcinoma (HCC-CC) is a rare type of liver cancer. We herein report a case of HCC-CC with lymph node metastases treated by multimodality therapy. The patient has been alive for more than 42 months. A 52-year-old man with a 9 cm diameter mass lesion in the liver was admitted to our hospital. The tumor was diagnosed as peripheral type of cholangiocarcinoma. Preoperative transhepatic arterial chemoenbolization (TACE) was performed. An accumulation pattern of lipiodol after TACE and an increase of serum alpha-fetoprotein led us to diagnosis of combined HCC-CC. A three segmentectomies of the liver and dissection of the local lymph nodes were performed. A histological examination of the resected specimen showed combined HCC-CC with lymph node metastases. Alpha fetoprotein, cytokeratins 7 and 19 were partially positive with immunohistochemical staining. The final diagnosis was a mixed type of combined HCC-CC. To improve a poor prognosis of combined HCC-CC, adjuvant chemotherapy with CDDP, 5 FU and radiation therapy were achieved. Fortunately, the patient is alive without any recurrence for 42 months after the operation.
authors.affiliation: Dept. of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ishiko
authors.forename: Takao
authors.initials: T
authors.lastname: Mizumoto
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Okabe
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Baba
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kanemitsu
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hiroto
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000401:mortality / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D053539:Keratin-19 / Q000032:analysis; D053552:Keratin-7 / Q000032:analysis; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000628:therapy*; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D053539:Keratin-19; D053552:Keratin-7; D000509:alpha-Fetoproteins; D002945:Cisplatin; D005472:Fluorouracil