2023 Volume 37 Issue 4 Pages 811-819
A man in 60s was referred to our hospital presenting with jaundice. Contrast-enhanced CT revealed contrast effects suggestive of a neoplastic lesion in the hilar bile duct. ERCP showed stenosis of the hilar bile duct, leading to a cytological staging of Class V. The patient was diagnosed with hilar cholangiocarcinoma (cT4aN0M0, cStage IVA) and gemcitabine/cisplatin/S-1 (GCS) therapy was commenced. The tumor reduced on CT performed after 4 courses of chemotherapy. However, adenocarcinoma was detected on biopsy after 14 courses. After 17 courses, Grade 4 neutropenia/thrombocytopenia appeared and the treatment was switched to S-1 monotherapy. Cholangioscopic bile duct biopsy at 28 months after GCS therapy was negative. Chemotherapy was discontinued four years nine months ago, with maintenance of complete response till the present time.
