A 77-year-old woman visited a nearby hospital with abdominal pain in June 2009. Calculus cholecystitis was suspected from the findings of abdominal US and CT; thus, the patient was referred to our department. The enlarged gallbladder was palpable in the right hypochondrium, but the abdomen was soft and there was no tenderness. Abdominal US, CT, and MRI showed significant enlargement and wall thickness of the gallbladder. Gallstones were noted in the gallbladder neck, and retention of inspissated bile or biliary sludge was suspected; however, no evident tumorous lesions were identified. A diagnosis of calculus cholecystitis was made and cholecystectomy was performed. Histopathological examination of the resected specimen revealed findings consistent with mixed adenoneuroendocrine carcinoma, and additional regional lymph node dissection for gallbladder cancer was performed. The regional lymph nodes showed evidence of metastasis, and the final clinical staging was stage IIIB. Adjuvant chemotherapy with gemcitabine hydrochloride was administered; however, CT and PET after the completion of chemotherapy revealed metastases in segment 8 of the liver and abdominal para-aortic lymph nodes. CPT-11 monotherapy was started based on the treatment strategy for recurrent small cell lung cancer, resulting in the disappearance of the metastatic foci. To the best of our knowledge, this is the first case report in which complete remission was achieved by CPT-11 for recurrent mixed adenoendocrine carcinoma. The present case suggests the usefulness of CPT-11.
ASJC Scopus subject areas