A case of unresectable combined hepatocellular cholangiocarcinoma showing favorable response to LFP therapy

Sayuri Kato, Yasuto Takeuchi, Nozomu Wada, Yuuki Morimoto, Kenji Kuwaki, Hideki Ohnishi, Shinichiro Nakamura, Hidenori Shiraha, Akinobu Takaki, Hiroyuki Okada

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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-ethoxybenzyldiethylenetriamine 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.

Original languageEnglish
Pages (from-to)2050-2056
Number of pages7
JournalJournal of Japanese Society of Gastroenterology
Volume113
Issue number12
Publication statusPublished - 2016

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Cholangiocarcinoma
Neoplasms
Magnetic Resonance Imaging
Cisplatin
Therapeutics
Hepatocellular Carcinoma
Liver
Intra-Arterial Injections
Drug Therapy
Gadolinium
Portal Vein
Fluorouracil
Thrombosis
Biopsy
Acids
Survival

ASJC Scopus subject areas

  • Gastroenterology

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A case of unresectable combined hepatocellular cholangiocarcinoma showing favorable response to LFP therapy. / Kato, Sayuri; Takeuchi, Yasuto; Wada, Nozomu; Morimoto, Yuuki; Kuwaki, Kenji; Ohnishi, Hideki; Nakamura, Shinichiro; Shiraha, Hidenori; Takaki, Akinobu; Okada, Hiroyuki.

In: Journal of Japanese Society of Gastroenterology, Vol. 113, No. 12, 2016, p. 2050-2056.

Research output: Contribution to journalArticle

Kato, Sayuri ; Takeuchi, Yasuto ; Wada, Nozomu ; Morimoto, Yuuki ; Kuwaki, Kenji ; Ohnishi, Hideki ; Nakamura, Shinichiro ; Shiraha, Hidenori ; Takaki, Akinobu ; Okada, Hiroyuki. / A case of unresectable combined hepatocellular cholangiocarcinoma showing favorable response to LFP therapy. In: Journal of Japanese Society of Gastroenterology. 2016 ; Vol. 113, No. 12. pp. 2050-2056.
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AU - Kuwaki, Kenji

AU - Ohnishi, Hideki

AU - Nakamura, Shinichiro

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AB - 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-ethoxybenzyldiethylenetriamine 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.

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