Cancer Research and Treatment

Case Report

A Case of Combined Hepatocellular-Cholangiocarcinoma with Favorable Response to Systemic Chemotherapy: Gun Min Kim, Hei-Cheul Jeung, Dokyung Kim, Joo Hoon Kim, Sang Hyun Yoon, Eun Suk Jung, Sang Joon Shin; Cancer Res Treat. 2010;42(4):235-238. Published online December 31, 2010; DOI: https://doi.org/10.4143/crt.2010.42.4.235

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare form of primary liver cancer composed of cells with histopathologic features of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). Because of its low incidence, the information on clinical outcomes of cHCC-CC is very limited and there are no published reports describing non-surgical treatment options for cHCC-CC. We report a case of cHCC-CC exhibiting a favorable response to systemic chemotherapy with doxorubicin and cisplatin. A 62-year-old man who recurred after a right lobectomy for cHCC-CC received sorafenib for palliative systemic therapy, but follow up imaging studies showed disease progression. He received 2nd line chemotherapy with doxorubicin at 60 mg/m² together with cisplatin at 70 mg/m². After 2 cycles of chemotherapy, a computed tomography scan of the chest showed markedly decreased size and number of the multiple lung metastases. After completing 8 cycles of 2nd line therapy, we changed the regimen to a fluorouracil (5-FU) mono therapy because of the toxicities associated with doxorubicin and cisplatin. To date, the patient has completed his 15th cycle of 5-FU mono therapy with the disease status remaining stable during 18 months of follow-up.

Citations

Citations to this article as recorded by

Combined Hepatocellular-Cholangiocarcinoma: Biology, Diagnosis, and Management
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Original Article

Wernicke's Encephalopathy in Advanced Gastric Cancer: Eun Suk Jung, Obin Kwon, Soo Hyun Lee, Ki Byung Lee, Joo Hoon Kim, Sang Hyun Yoon, Gun Min Kim, Hei-Cheul Jeung, Sun Young Rha; Cancer Res Treat. 2010;42(2):77-81. Published online June 30, 2010; DOI: https://doi.org/10.4143/crt.2010.42.2.77

Abstract PDF PubReader ePub

Purpose

With their prolonged survival and malnutrition, cancer patients, and especially gastrointestinal (GI) tract cancer patients, can develop Wernicke's encephalopathy (WE). The aim of this study is to remind physicians of the importance of WE and prompt management in patients with GI tract cancer.

Materials and Methods

This study is a retrospective review of 2 cases of WE in advanced gastric cancer (AGC) patients, and we review the literature for cases of GI tract cancer related to WE.

Results

A 48-year-old female with AGC presented dizziness and diplopia for 5 days and a 20 kg weight loss. Neurologic exam showed nystagmus and gaze disturbance. Her symptoms improved after daily parenteral injection of thiamine 100 mg for 17 days. A 58-year-old female with AGC presented with sudden disorientation, confusion and 15 kg weight loss. Neurologic exam showed gaze limitation and mild ataxia. Despite daily parenteral injection of thiamine 100 mg for 4 days, she died 5 days after the onset of neurologic symptoms. Combining the cases noted in the literature review with our 2 cases, the 7 gastric cancer cases and 2 colorectal cancer cases related to WE showed similar clinical characteristics; 1) a history of long-period malnutrition and weight loss, 2) relatively typical neurologic signs and symptoms and 3) specific magnetic resonance image findings. Except for 2 patients who had irreversible neurologic symptoms, the other 7 patients were improved with prompt thiamine treatment.

Conclusion

It is important to consider WE in GI tract cancer patients with acute neurologic symptoms and who are in a state of malnutrition. Thiamine should be given as soon as possible when WE is suspected.

Citations

Citations to this article as recorded by

Duodenal Adenocarcinoma in the Setting of Bariatric Surgery: A Perfect Storm for Wernicke’s Encephalopathy
Aliza Gross, Allen T Yu, Jacques Lara-Reyna, Koji Park, Eugenius J Harvey
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Frontiers in Nutrition.2023;[Epub] CrossRef
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Oumayma Lahnaoui, Nezha EL Bahaoui, Sara El Atiq, Laila Amrani, Mohammed Anass Majbar, Amine Benkabbou, Raouf Mohsine, Amine Souadka
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Filomena Gomes, Gilles Bergeron, Megan W. Bourassa, Philip R. Fischer
Annals of the New York Academy of Sciences.2021; 1498(1): 46. CrossRef
WERNICKE ENCEPHALOPATHY IN A PATIENT WITH GASTRIC CANCER RECURRENCE AFTER UPPER GASTROINTESTINAL SURGERY: A CASE REPORT AND REVIEW OF THE LITERATURE
Zining Liu, Xin Ye, Jiejin Yang, Zeyang Chen
Gastroenterology Nursing.2020; 43(6): 463. CrossRef
Wernicke's encephalopathy in a subject with enter-colic fistula
Daniele Canova, Paola Scalon, Fabio Monica, Stefano A. Grassi, Anna Giacomin, Tiziana Tumelero, Gaetano Mastropaolo, Francesco Malfa
Gazzetta Medica Italiana Archivio per le Scienze Mediche.2019;[Epub] CrossRef
Wernicke's encephalopathy in a patient with non-Hodgkin's lymphoma post-Autologous HSCT
João Paulo de Vasconcelos Leitão, Romélia Pinheiro Gonçalves Lemes, Maritza Cavalcante Barbosa, Beatriz Stela Gomes de Souza Pitombeira Araújo, Karine Sampaio Nunes Barroso, Jacques Kaufman, Talyta Ellen de Jesus dos Santos, Anna Thawanny Gadelha Moura, A
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Ju Hyun Seo, Ju Hee Kim, Der Sheng Sun, Hye Sung Won, Jeong Wook Park, Yoon Ho Ko
The Korean Journal of Internal Medicine.2017; 32(6): 1112. CrossRef
The Role of Thiamine and Effects of Deficiency in Dogs and Cats
Georgia Kritikos, Jacqueline Parr, Adronie Verbrugghe
Veterinary Sciences.2017; 4(4): 59. CrossRef
Association between malignancy and non-alcoholic Wernicke's encephalopathy: a case report and literature review
Evan Y. Choi, William A. Gomes, Missak Haigentz, Jerome J. Graber
Neuro-Oncology Practice.2016; 3(3): 196. CrossRef
Wernicke encephalopathy as rare complication of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
Antonio Macrì, Francesco Fleres, Antonio Ieni, Maurizio Rossitto, Tommaso Mandolfino, Salvatore Micalizzi, Francesco Iaropoli, Carmelo Mazzeo, Massimo Trovato, Eugenio Cucinotta, Edoardo Saladino
International Journal of Surgery Case Reports.2015; 16: 29. CrossRef
Two Cases of Wernicke's Encephalopathy That Developed during Total Parenteral Nutrition in Colon Cancer Patients Treated with 5-Fluorouracil-based Chemotherapy
Kyung Pyo Cho, Jae Sung Lee, Ji Seok Seong, Yong Moon Woo, Young Jun Cho, Beom Jin Jeong, Jee Hoon Sohn, Su-Jung Kim
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Wernicke-Korsakoff Syndrome in Primary Peritoneal Cancer
Ki Hyang Kim
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