Abstract
A 69 year-old woman was diagnosed as advanced stage gall bladder cancer with hilar and peripancreatic lymph nodes metastasis. It was suspected that those lymph nodes would invade to hepatic artery and portal vein. Chemo-radiation therapy was initiated because curative resection was considered impossible. After administration of S-1 combined with radiation (65Gy) therapy followed by GEM/CDDP chemotherapy, she was diagnosed as partial response, and then she was referred to our hospital for surgery. CT scan revealed no tumor mass in the gallbladder and necrotic changes suspected in the lymph node. We performed gallbladder bed resection, pancreatoduodenectomy and lymph node dissection. Histopathological examination revealed atypical cells formed irregular glandular structures in a small section of the gallbladder, diagnosed well-differentiated tubular adenocarcinoma. A few residual atypical cells were also present in lymph node No. 13a. Final diagnosis was T1b N1 M0 (stage IIIB). She is alive without recurrence at 24 months after surgery. Although advanced gallbladder cancer has a poor prognosis, multidisciplinary treatment including surgery may help improve pateints' outcomes.
