Journal of Digestive Cancer Research

  • 제1권2호
  • /
  • Pages.104-107
  • /
  • 2013
  • /
  • 2950-9394(pISSN)
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  • 2950-9505(eISSN)
대한소화기암연구학회 (Korean Society of Gastrointestinal Cancer Research)
권호 표지

항암화학요법에 이은 확대 담낭절제술로 치료한 절제 불가능한 담낭암

A Case of Unresectable Gallbladder Cancer Treated with Chemotherapy Followed by Extended Cholecystectomy

  • 정광현 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 박진명 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 이재민 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 이상협 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 류지곤 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 김용태 (서울대학교 의과대학 내과학교실, 간연구소)
  • Kwang Hyun Chung (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Jin Myung Park (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Jae Min Lee (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Sang Hyub Lee (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Ji Kon Ryu (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Yong-Tae Kim (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
  • 투고 : 2013.09.04
  • 심사 : 2013.10.24
  • 발행 : 2013.11.30
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초록

담낭암은 진행된 상태에서 발견되었을 경우 예후가 매우 불량한 암으로 전신항암화학요법으로 치료를 하게 되나 일반적으로 고식적인 역할에 그치는 경우가 대부분이다. 본 증례는 원위부 림프절 전이가 있어서 수술적 절제가 불가능한 담낭암 환자에서 gemcitabine과 cisplatin을 병합한 전신항암화학요법으로 여섯 주기 치료 후 부분 관해를 얻어서 확대 담낭절제술이 가능하였던 증례로 매우 드문 증례를 경험하였기에 보고하는 바이다. 담낭암에서 수술 전 항암화학요법의 효과는 아직까지 확립되어 있지 않으나, 최근 양호한 종양 반응률과 종양 억제율을 보이는 항암화학요법이 개발됨에 따라서 그 가능성이 기대되고 있다.

Gallbladder (GB) cancer is highly malignant neoplasm found in advanced stage and chemotherapy commonly plays a palliative role in GB cancer. We report a case of unresectable GB cancer treated with chemotherapy followed by extended cholecystectomy. Fifty-six-year-old male visited our hospital with weight loss and dyspnea on exertion. Computed tomography detected pulmonary embolism and diffuse GB wall thickening with para-aortic lymph node enlargement. The length of common channel was 23mm at magnetic resonance cholangiopancreatography which stands for anomalous union of the pancreaticobiliary duct. Anticoagulation was started for pulmonary embolism. GB wall mass was regarded as unresectable GB cancer with distant lymph node metastasis. Gemcitabine and cisplatin combination chemotherapy was carried out for 6 cycles. Primary tumor was stationary but multiple enlarged lymphnodes were almost completely disappeared. Extended cholecystectomy with hepaticojejunostomy was performed. Post-operative tumor stage was T3N1 (stage IIIB) and R0 resection was achieved. After operation he has no evidence of disease recurrence for 6 months.

키워드

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