title: A case of unresectable combined hepatocellular cholangiocarcinoma showing favorable response to LFP therapy.
abstract: A woman in her 50s was admitted to our hospital because of multiple tumors detected in her liver. She was diagnosed with combined hepatocellular cholangiocarcinoma using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and biopsy of the liver tumors. We judged the tumors to be unresectable because they were found in both lobes of the liver, with a tumor thrombus being found in the main left portal vein. The pathological findings showed that the tumors exhibited characteristics of hepatocellular carcinoma. Therefore, sorafenib was administered;however, 6 months later, the disease progressed. Consequently, she received second-line chemotherapy with a one-shot intra-arterial injection of cisplatin, but this too was ineffective, and her general condition worsened. As hence, we changed the regimen to 5-fluorouracil continuous infusion and consecutive low dose cisplatin (LFP) therapy. After one cycle of chemotherapy with LFP, Gd-EOB-DTPA-enhanced MRI showed markedly decreased sizes and numbers of tumors. To date, she has completed six cycles of LFP therapy, and almost all her tumors are no longer visible on MRI. She has recovered to a good state and has achieved long-term survival. Thus, this case indicates that although LFP therapy is generally selected for cases of advanced hepatocellular carcinoma, it also appears to be effective for long-term disease control in cases of hepatocellular cholangiocarcinoma.
authors.affiliation: Department of Gastroenterology, Okayama University Hospital.
authors.forename: Sayuri
authors.initials: S
authors.lastname: Kato
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Nozomu
authors.initials: N
authors.lastname: Wada
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Morimoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Kuwaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Nakamura
authors.forename: Hidenori
authors.initials: H
authors.lastname: Shiraha
authors.forename: Akinobu
authors.initials: A
authors.lastname: Takaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil