Case Report
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World J Hematol. Nov 6, 2013; 2(4): 115-118
Published online Nov 6, 2013. doi: 10.5315/wjh.v2.i4.115
Gemcitabine cures metastatic hepatic carcinoma and bone metastasis
Chih-Chao Yang, Wai-Kevng Chow, Yen-Chun Peng, Ran-Ching Wang
Chih-Chao Yang, Divisions of Gastroenterology and Hepatology, Department of Medicine, Chang-Hua Hospital, Changhua County 513, Taiwan
Wai-Kevng Chow, Divisions of Gastroenterology and Hepatology, Department of Medicine, China Medical University Hospital, Taichung, 40447, Taiwan
Yen-Chun Peng, Divisions of Gastroenterology and Hepatology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
Ran-Ching Wang, Department of Pathology and Laboratory Medicine, Taichung Veteran General Hospital, Taichung, Taiwan
Author contributions: Yang CC is the main author and wrote this paper; Chow WK established the first clinical contact with the patient and provided the clinical data; Chow WK, Peng YC also helped with performing the ERCP and the clinical discussion; Wang RC was the pathologist in charge of the tissue sample of this case.
Correspondence to: Wai-Kevng Chow, MD, Divisions of Gastroenterology and Hepatology, Department of Medicine, China Medical University Hospital, No. 2 Yude Road, Taichung 40447, Taiwan. chowan68@yahoo.com.tw
Telephone: 886-4-22052121 Fax: 886-4-22523425
Received: April 9, 2013
Revised: August 14, 2013
Accepted: August 28, 2013
Published online: November 6, 2013
Abstract

We report a case of a 59-year-old gentleman who had suffered from low back pain for several months. Abdominal sonogram showed multiple heteroechoic nodules in the bilateral liver and an enlarged pancreatic head. Abdominal computer tomography (CT) favored pancreas head tumor with liver and bone metastasis. Endoscopic retrograde cholangiopancreatography (ERCP) disclosed pancreatic duct invasion over the distal portion of the pancreatic duct with prestenotic dilatation. Liver biopsy showed undifferentiated carcinoma. As suggested by the pathologist, the nasopharyngeal area was checked by the ear, nose and throat doctor, was negative and nasopharyngeal carcinoma was excluded. Therefore, the patient was treated with Gemcitabine (1500 mg/wk), as the suggested treatment schedule, for 24 wk in opioid dependency program. Sequential abdominal CT during follow up showed the disappearance of liver metastasis and shrinkage of the pancreatic tumor. Repeated ERCP after treatment showed re-channelization of the pancreatic duct. During 11 years of follow up, 5 CT scans disclosed not only the disappearance of the hepatic tumor but also no cancer recurrence. Progressive shrinkage of pancreatic head was also noted. Therefore, we can say this malignant case was cured by monotherapy with gemcitabine.

Keywords: Gemcitabine, Gemza, Cure, Metastatic hepatic carcinoma, Undifferentiated carcinoma, Bone metastasis