Surgical Case Reports (Jul 2019)

Conversion surgery for initially unresectable carcinoma of the ampulla of Vater following pathological complete response to chemotherapy: a case report

  • Yo Sato,
  • Takanobu Hara,
  • Yuko Takami,
  • Yoshiyuki Wada,
  • Tomoki Ryu,
  • Shin Sasaki,
  • Munehiro Yoshitomi,
  • Seiya Momosaki,
  • Masatoshi Murakami,
  • Masayuki Hijioka,
  • Toyoma Kaku,
  • Ken Kawabe,
  • Hideki Saitsu

DOI
https://doi.org/10.1186/s40792-019-0680-z
Journal volume & issue
Vol. 5, no. 1
pp. 1 – 6

Abstract

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Abstract Background Carcinoma of the ampulla of Vater with distant metastases is regarded as unresectable. Systemic chemotherapy is basically the treatment of choice for such tumors. Case presentation A 68-year-old woman was referred to our hospital and diagnosed with carcinoma of the ampulla of Vater with lymph node and multiple liver metastases. She underwent systemic chemotherapy with a combination of gemcitabine and cisplatin. After 19 months of treatment, the primary tumor and liver metastases were difficult to detect on follow-up images. Shrinkage of the enlarged lymph nodes was also confirmed. Surgical resection was performed with curative intent after a multidisciplinary meeting. Pathological examination of the resected specimen showed no residual tumors. Systemic chemotherapy achieved a pathological complete response. The postoperative course was uneventful, and the patient remained free of recurrent disease at 10 months of follow-up. Conclusion This case shows the possibility of conversion surgery after systemic chemotherapy for carcinoma of the ampulla of Vater.

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