title: [A Case of Peritoneal Dissemination of Hilar Cholangiocarcinoma Presenting with Hematuria Six Years after Radical Surgery].
abstract: A 76-year-old man underwent radical surgery for Stage IV a hilar cholangiocarcinoma in July 2009, and had been followed at an outpatient clinic. Although no apparent recurrent lesion was detected by PET/CT examination, an elevated CA19-9 level was found in January 2014. He was then started on the oral anticancer drug S-1. However, his CA19-9 level increased gradually. The patient presented to a urological department with a complaint of macrohematuria in May 2015. Detailed examination revealed a mass lesion at the top of the urinary bladder, which was suspected to be peritoneal dissemination of the known hilar cholangiocarcinoma invading the urinary bladder wall. Thus, he underwent partial resection of the urinary bladder in July 2015. A histopathological examination of the resected specimen confirmed the diagnosis of recurrence. The patient is nowreceiving chemotherapy with gemcitabine and cisplatin. Detection of recurrences of cholangiocarcinoma is often difficult since the recurrence pattern of cholangiocarcinoma varies widely. However, early detection might enable longterm survival by adequate treatment including chemotherapy. Therefore, thorough multidisciplinary examinations are required when recurrence of cholangiocarcinoma is suspected. In addition, long-term follow-up after radical surgery is required since cholangiocarcinoma sometimes shows slow progression.
authors.affiliation: Dept. of Surgery, Nishijin Hospital.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Koizumi
authors.forename: Yuen
authors.initials: Y
authors.lastname: Nakase
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takagi
authors.forename: Kanehisa
authors.initials: K
authors.lastname: Fukumoto
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D018285:Klatskin Tumor / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008297:Male; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000556:secondary*; D013997:Time Factors; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine