Successful Multidisciplinary Therapy for Small Cell Carcinomas Arising from the Extrahepatic Bile Duct

Abstract

A 74-year-old man was diagnosed with small cell carcinoma arising from the extrahepatic bile duct according to a histological examination of the biopsy specimen obtained during endoscopic retrograde cholangiopancreatography. Additionally, bulky hilar lymphadenopathy was observed, and the patient was treated with the combination of radiation and chemotherapy (cisplatin and irinotecan). Post-therapy, he underwent pancreaticoduodenectomy. The histological examination of the resected specimen revealed no residual cancer cells in the bile duct wall and a small amount of cancer cells in only a single lymph node. Due to this multidisciplinary therapy, the patient showed no signs of recurrence 12 months postoperatively.

Neuroendocrine carcinoma of the common hepatic duct coexisting with distal cholangiocarcinoma: A case report and review of literature

“…Percutaneous transhepatic cholangiography (PTC), endoscopic brushing examination and needle biopsy can be used to obtain preoperative pathological results for diagnosis, but the positivity rate is low. In this study, 2 patients were pathologically confirmed by preoperative PTC[ 13 , 23 ], and 8 patients were pathologically confirmed by endoscopic biopsy[ 1 , 14 , 35 - 37 , 42 , 43 , 46 ]. The diagnosis of NEC often relies on immunohistochemistry, and there are a specific set of markers, such as neuron-specific enolase, CgA, Syn, and Ki-67, and cluster of differentiation 5.…”

“…To date, adjuvant therapy for EBNEC lacks standardization, and the roles of chemotherapy, radiotherapy and immunotherapy are still unclear. Commonly used chemotherapy regimens include cisplatin and etoposide[ 17 , 22 , 26 , 38 , 44 ] and cisplatin and irinotecan[ 37 , 39 , 50 ]. As neoadjuvant chemotherapy regimens, these two regimens can successfully achieve conversion.…”

“…As neoadjuvant chemotherapy regimens, these two regimens can successfully achieve conversion. In this study, 4 patients received subsequent surgical treatment and achieved an overall survival (OS) of 16-23 months[ 13 , 14 , 23 , 37 ]. For NEC recurrence or metastasis, radiotherapy, transarterial chemoembolization, and ablation therapy should be considered.…”