Abstract
A 69-year-old man who had undergone pancreaticoduodenectomy for adenosquamous carcinoma of the intrapancreatic remnant bile duct in June 2006 was admitted to the hospital because of fever about six months after the surgery. Severe inflammatory findings were noted and serum CEA level was elevated. Abdominal US and CT scan revealed a liver tumor in the S7 of the liver. It was difficult to differentiate between metastasis and an abscess. No symptomatic remission was gained by conservative therapy and an increasing tendency of the tumor was observed. Then needle puncture was performed after all. The histopathological examination revealed liver metastasis of adenosquamous carcinoma of the bile duct. Hepatic arterial infusion therapy with 5-FU+CDDP was performed. The liver tumor subsequently shrank, uncontrollable inflammation improved, and the serum CEA level fell to normal range.
Adenosquamous carcinoma of the bile duct carries extremely poor prognosis and is prone to recur or metastasize in an early phase. No effective multimodal therapy for the disease has been established as yet. We suggest that the hepatic arterial infusion therapy with 5-FU+CDDP is a useful therapy for liver metastasis of adenosquamous carcinoma of the bile duct.
