Comment
Author: Admin | 2025-04-28
Shown in (a) and case 2 shown in (b). Both graphs also show the time course of systemic therapy (blue: gemcitabine/cisplatin; orange: ivosidenib; green: 5-irinotecan-based therapy). In case 2, tumor marker assessment prior to treatment with ivosidenib is not available.Fig. 2.Time course of CA19-9 from initial diagnosis to last presentation. Time course of the serologic tumor marker CA19-9 (values in U/mL) from initial diagnosis to last presentation in our department for case 1 shown in (a) and case 2 shown in (b). Both graphs also show the time course of systemic therapy (blue: gemcitabine/cisplatin; orange: ivosidenib; green: 5-irinotecan-based therapy). In case 2, tumor marker assessment prior to treatment with ivosidenib is not available. Close modal Case 1 In August 2013, a 60-year-old female patient presented to our clinic with a feeling of pressure in the right upper quadrant of the abdomen. A magnetic resonance imaging of the liver showed a 10 × 9 cm large liver lesion involving segments IVa, IVb, and V. The serum tumor marker CA19-9 level was not increased. The patient underwent oncological tumor resection. Histological examination revealed a pT3 pN1 L1 V0 Pn1 G2 R1 CCA with gallbladder invasion. After recovery, the patient received additive systemic therapy with gemcitabine. Sixteen months after the resection, a new CCA manifestation in the liver segment II was surgically resected. Additional isolated metachronous lung, liver, and peritoneal lesions (i.e., oligometastatic disease) were then treated with local ablative procedures (microwave ablation, radiofrequency ablation, and interstitial brachytherapy) or surgical resection (the sequence of local therapies is shown in Table 1). In April 2018, because of progressive peritoneal disease not amenable for surgical resection, palliative systemic therapy with gemcitabine/cisplatin was initiated, resulting in partial remission after four cycles. On October 2018, in a chemotherapy-free interval, localized progressive disease in the liver was treated
Add Comment