[A Case of Successful Control of Advanced Duodenal Cancer with Liver Metastasis Receiving Paclitaxel Chemotherapy and Potential Radical Resection]

Gan To Kagaku Ryoho. 2018 Dec;45(13):2321-2323.
[Article in Japanese]

Abstract

We report a case of successful control of advanced duodenal cancer with paclitaxel chemotherapy. A woman in her 70s with epigastralgia was diagnosed with hemorrhagic duodenal ulcer upon upper gastrointestinal endoscopy. A type 3 tumor was found in the duodenal bulb upon upper gastrointestinal endoscopy and biopsy at our hospital. By contrast CT, we found wall hypertrophy of the duodenal bulb, lymph node metastasis, and liver metastasis and started chemotherapy. Four courses of SOX therapy were first administered. The wall hypertrophy of the duodenal bulb worsened, and new lesions appeared in the liver, so we diagnosed progressive disease. Next, 4 courses of wPTX therapy were administered. The wall hypertrophy of the duodenal bulb improved, and all liver metastatic lesions shrunk and became obscure. The reduction rate was 75%, so we diagnosed partial response. Accumulation in the primary tumor was observed on PET-CT, and the lymph node and liver metastases disappeared, so we considered radical curative resection. The patient underwent subtotal stomach preserving pancreatoduodenectomy, D2 lymph node dissection, reconstruction of the digestive tract by the modified CHILD method, partial hepatectomy, and Brawn's anastomosis. No cancer cells were found in the hepatectomized area. Paclitaxel chemotherapy may be useful for advanced duodenal cancer.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Duodenal Neoplasms* / drug therapy
  • Duodenal Neoplasms* / pathology
  • Duodenal Neoplasms* / surgery
  • Female
  • Humans
  • Liver Neoplasms* / drug therapy
  • Liver Neoplasms* / secondary
  • Lymphatic Metastasis
  • Paclitaxel / therapeutic use
  • Positron Emission Tomography Computed Tomography

Substances

  • Antineoplastic Agents, Phytogenic
  • Paclitaxel