A Case of Conversion Surgery for Gallbladder Cancer with Para-Aortic Lymph Node Metastasis

The study presents the case of a 71-year-old woman who visited a nearby hospital for epigastric pain and weight loss. A CT scan showed a mass in the gallbladder, and the CEA level was high, so she was referred to our hospital for further investigation. Abdominal US, CT, and MRI suggested gallbladder...

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Bibliographic Details
Published inGan to kagaku ryoho Vol. 50; no. 4; p. 538
Main Authors Fukuda, Nijie, Hama, Naoki, Takiuchi, Daisuke, Shimaoka, Takahiro, Harada, Soichiro, Sato, Hiromichi, Matsuura, Yusuke, Munakata, Koji, Wada, Noriko, Takachi, Ko, Ota, Hirofumi
Format Journal Article
LanguageJapanese
Published Japan 01.04.2023
Subjects
Aged
Carcinoma in Situ - surgery
Cisplatin - therapeutic use
Deoxycytidine - therapeutic use
Female
Fluorodeoxyglucose F18 - therapeutic use
Gallbladder Neoplasms - drug therapy
Gallbladder Neoplasms - pathology
Gallbladder Neoplasms - surgery
Humans
Lymph Node Excision
Lymph Nodes - pathology
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Summary:The study presents the case of a 71-year-old woman who visited a nearby hospital for epigastric pain and weight loss. A CT scan showed a mass in the gallbladder, and the CEA level was high, so she was referred to our hospital for further investigation. Abdominal US, CT, and MRI suggested gallbladder cancer with para-aortic metastasis, and the histological findings on the EUS-FNA confirmed the diagnosis. Since surgical resection was not indicated, chemotherapy was performed(gemcitabine plus cisplatin). After 10 courses of chemotherapy, CT and MRI showed downsizing of para-aortic lymph nodes, and no accumulation of FDG was found on FDG-PET. Confirming the downstaging of cancer, conversion surgery, comprising an extended cholecystectomy and a lymph node resection, was performed. The pathological diagnosis showed no lymph node metastasis. No recurrence was observed after 12 months of surgery. Initially, unresectable gallbladder cancer with para-aortic lymph node metastasis was indicated to be compatible with preoperative chemotherapy and conversion surgery.
ISSN:0385-0684