title: [A Case of a Patient with Distal Bile Duct Carcinoma Who Underwent Surgical Resection Three Times for Pulmonary Metastases].
abstract: A 63-year-old woman attended our hospital after diagnosis of a solitary pulmonary metastasis from a distal bile duct carcinoma. She had undergone a subtotal stomach-preserving pancreaticoduodenectomy 1 year 9 months prior to the current presentation. She was treated with right thoracoscopic pulmonary partial resection. The specimen was a solitary nodule 5 mm in diameter. In addition, she was treated with adjuvant chemotherapy involving GEM for 6 months. One year 5 months later, she was diagnosed with a second pulmonary metastasis and was treated with a left thoracoscopic partial resection. Four months later, she experienced recurrence in the right lung stump and was treated with right thoracoscopic partial resection. The specimen was a solitary nodule 21 mm in diameter. Cytopathologic examination of the pleural fluid resulted in a diagnosis of Class Ⅴ. She was treated with adjuvant chemotherapy involving TS-1 for 6 months. Seven months later, she was experienced recurrence with multiple pulmonary metastases and an affected hilar lymph node. GEM/CDDP chemotherapy was started, but bone multiple metastases developed. After she received 30 Gy of radiotherapy, her pain improved. She died of cancer 5 years and 4 months after her initial pancreaticoduodenectomy, which was 3 years and 4 months after her initial pulmonary resection. We identified 14 other case reports of long-term survivors of distal bile duct carcinoma.
authors.affiliation: Dept. of Gastroenterological Surgery, Saitama Cancer Center.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Amikura
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Amane
authors.initials: A
authors.lastname: Takahashi
authors.forename: Toshiro
authors.initials: T
authors.lastname: Ogura
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Omichi
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Uramoto
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Akiyama
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Kensei
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hara
mesh_terms: D001650:Bile Duct Neoplasms / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary / Q000628:therapy*; D008875:Middle Aged; D016577:Pancreaticoduodenectomy