title: A patient with gallbladder cancer with paraaortic lymph node and hepatic metastases who has survived for more than 13 years after the primary extended radical operation.
abstract: Gallbladder cancer is a disease with poor prognosis, especially when it is associated with distant metastasis. Here we report a rare case of a patient with gallbladder cancer with extensive local and distant lymph node metastases and multiple liver metastases who has survived for more than 13 years through aggressive treatments. A 54-year-old woman developed right upper quadrant pain. Computed tomography (CT) revealed a papillary tumor in the gallbladder. Low-density tumors in segments 4, 5, and 8 of the liver and extensive paraaortic lymph node swelling were observed. She underwent central hepatic bisectionectomy and paraaortic lymphadenectomy. Two months later, hepatic metastases were found in segments 2, 3, 6, and 7, and percutaneous ethanol injection and transcatheter arterial chemoembolization were performed. Twelve months after the first surgery, CT revealed lymph node swelling around the right external iliac artery and behind the left renal vein. Metastatic lymph node dissection and resection and reconstruction of the right external iliac artery and vein with artificial graft replacements were performed. Two months later, CT revealed a paraesophageal lymph node swelling, which was treated by radiotherapy. At present, 13 years after the first surgery, and 11 years after the last radiotherapy, she is alive without any sign of recurrence.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Amemiya
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Koji
authors.initials: K
authors.lastname: Oda
authors.forename: Hideki
authors.initials: H
authors.lastname: Nishio
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ebata
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Abe
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Igami
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nimura
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde; D003131:Combined Modality Therapy; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D014057:Tomography, X-Ray Computed