医学
吉西他滨
埃罗替尼
肿瘤科
胰腺癌
内科学
甲胎蛋白
胰腺癌
化疗
癌症
肝细胞癌
表皮生长因子受体
作者
Osamu Inatomi,Rie Osaki,Ayano Sonoda,Shigeki Bamba,Shigeki Bamba,Makoto Shioya,Takashi Nishimura,Eiji Mekata,Yataro Daigo,Akira Andoh
标识
DOI:10.1093/annonc/mdu436.86
摘要
Abstract Although it has been reported that alpha-fetoprotein (AFP)-producing pancreatic cancer is derived from acinar cells, carcinoma from ductal cells is relatively rare. Here we report a case of AFP-producing pancreatic ductal adenocarcinoma that showed response to gemcitabine and erlotinib. Case: A 53-year-old woman presented with body weight loss and epigastralgia. MRI and CT scan revealed multiple tumors in the liver and a mass in the head of the pancreas. The origin was obscure because AFP and PIVKA-II serum levels were significantly elevated (34748 ng/ml, 474 mAU/ml, respectively), whereas CEA and CA19-9 were not. Finally, we diagnosed pancreatic ductal carcinoma (stage IVb) by liver biopsy. Gemcitabine (1000 mg/m2 on day 1, 8, and 15, every 4 weeks) and erlotinib (100 mg/body, day 1–28) were administrated as first-line chemotherapy. A partial response of the primary lesion and of the liver metastases was achieved, and serum levels of AFP and PIVKA-II significantly decreased. Although we switched to second-line chemotherapy (gemcitabine and S-1), 8 months later the patient died of liver failure due to the progression of the tumor. The tumor was classified as a poor/middle differentiated ductal adenocarcinoma by pathologic analysis, and it strongly expressed AFP detected by immunohistochemistry.
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