title: [A Case of Liver Metastasis of Ampullary Carcinoma That Developed Postoperatively That Was Effectively Treated with Gemcitabine plus Cisplatin].
abstract: A 75-year-oldman presenting with obstructive jaundice was referredto our hospital. Basedon a diagnosis of carcinoma of the ampulla of Vater, we performed pancreatoduodenectomy. Postoperative histopathological examination revealed a welldifferentiated papillotubular adenocarcinoma, T3, N0, M0, Stage III . Six months after surgery, an isolatedliver metastasis in S6 was identifiedon CT scan andMRI; therefore, we administeredgemcitabine plus cisplatin chemotherapy. After 6 courses of this regimen, a clinical complete response(CR)was obtained. After 12 courses, the clinical CR continued; however, grade 3 lower-extremity peripheral neuropathy appeared. Therefore, gemcitabine monotherapy was administered as second line chemotherapy. However, multiple liver metastases appearedandthe patient passedaway owing to exacerbation of the disease 2 years after initiating chemotherapy. Although recurrent ampullary carcinoma is difficult to treat, our patient had a long-term survival. Here we report the details of our case and review the relevant literature.
authors.affiliation: Dept. of Surgery, Kinan Hospital.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamabe
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Hayashi
authors.forename: Toshiya
authors.initials: T
authors.lastname: Michiura
authors.forename: Tomo
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Keita
authors.initials: K
authors.lastname: Okubo
authors.forename: Shigeo
authors.initials: S
authors.lastname: Fujita
authors.forename: Makio
authors.initials: M
authors.lastname: Nagaoka
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003138:Common Bile Duct Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004379:Duodenal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D016577:Pancreaticoduodenectomy; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine