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Case Reports: Learning from unexpected outcome (positive or negative)
Prolonged survival with first-line chemotherapy in advanced extrahepatic cholangiocarcinoma
  1. Mascarenhas Chrystle1,2 and
  2. D'souza Sanyo3
  1. 1Pulmonary Medicine/Medical Oncology, KMC Hospital Ambedkar Circle, Mangalore, Karnataka, India
  2. 2Oncology, Nottingham University Hospitals NHS Trust, Nottingham, UK
  3. 3Medical Oncology, KMC Hospital Ambedkar Circle, Mangalore, Karnataka, India
  1. Correspondence to Dr Mascarenhas Chrystle; chrystle_mascarenhas{at}outlook.com

Abstract

Biliary tract cancer accounts for roughly 3% of adult malignancies of the gastrointestinal system. First-line treatment with gemcitabine–cisplatin chemotherapy is the standard for the management of metastatic biliary tract cancers. We present the case of a man who presented with abdominal pain, decreased appetite and weight loss for 6 months. Baseline evaluation revealed a liver hilar mass with ascites. Imaging, tumour markers, histopathology and immunohistochemistry revealed the diagnosis of metastatic extrahepatic cholangiocarcinoma. He was treated with gemcitabine–cisplatin chemotherapy followed by maintenance chemotherapy with gemcitabine and demonstrated an exceptionally good response and tolerance to chemotherapy with no long-term toxicity so far on maintenance therapy and progression-free survival exceeding 2.5 years after diagnosis. The rarity of this case is the exhibition of prolonged clinical response with maintenance chemotherapy for an aggressive cancer, thus needing further research into duration and outcomes of maintenance chemotherapy.

  • Oncology
  • Chemotherapy

https://doi.org/10.1136/bcr-2022-249681

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    Footnotes

    • Contributors AMC and DS managed the case. AMC contributed to the concept, design, literature search and manuscript preparation. DS contributed to the definition of intellectual content and manuscript editing. Both authors contributed to the manuscript review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.