Four Times Hepatectomy for Liver Metastasis from Carcinoma of the Papilla of Vater: Case Report

Abstract

Liver metastasis of carcinoma of the papilla of Vater related with poor prognosis and contraindication of surgery.

A woman aged 55 years was referred to our clinic for the follow-up of a adenoma of the papilla of Vater and an elevation of CA19-9. 5cm hepatic mass is detected at S5. She had undergone partial hepatctomy (S5) and the tumor was considered metastatic adenocarcinoma.

We found the polyp progression from dysplasia to carcinoma, and performed open pancreaticoduodenectomy with D2 lymph node dissection (SM, N0, H1 Stage Ⅳ). After the first surgery, she received TS-1 adjuvant chemotherapy.

6 months after the first surgery, three liver metastasis was detected. Chemotherapy was started and complete response. The clinical effects was complete response.

Single liver metastasis was detected at 2 years and 4 months, 5 years and 4 months , 8 years and 8 months after the first surgery. So we had perfomed repeat hepatetomy for three times because it was the single metastasis, and there were no extrahepatic metastasis.

She is alive without a recurrence for 13years and 4months after the first surgery.