Published online Nov 6, 2013. doi: 10.5315/wjh.v2.i4.115
Revised: August 14, 2013
Accepted: August 28, 2013
Published online: November 6, 2013
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.