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J Oncol Pharm Pract. 2015 Oct;21(5):396-9. doi: 10.1177/1078155214531512. Epub 2014 Apr 18.

Mitomycin-based hepatic arterial infusion chemotherapy for solitary ampullary cancer liver metastasis: an unusual treatment for an uncommon disease.

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Division of Medical Oncology, San Vincenzo Hospital, Taormina, Italy
Division of Diagnostic and Interventional Radiology, San Vincenzo Hospital, Taormina, Italy.
Division of Medical Oncology, San Vincenzo Hospital, Taormina, Italy.


Ampullary carcinoma is an uncommon gastrointestinal disease. Its natural history is often characterized by the occurrence of liver metastases. Among patients who undergo pancreatoduodenectomy, those presenting with lymph nodes involvement are more prone to early distant disease relapse. In this report, a patient previously diagnosed with ampullary carcinoma had been treated with curative surgery. After subsequent adjuvant gemcitabine, the patient developed significant myelotoxicity and suffered from a single liver metastasis a few months later. A hepatic intra-arterial mitomycin plus fluorouracil-based chemotherapy was administered in order to avoid any serious systemic toxicity. The treatment was well tolerated and no serious side effects occurred. Extra-hepatic cancer relapse, involving intra-thoracic and abdominal lymph nodes, was observed not long after the initial intra-hepatic almost complete response. In conclusion, the locoregional chemotherapy administration was effective in overcoming any systemic toxicities and showed activity against the liver metastasis but it did not prevent extra-hepatic cancer dissemination.


Mitomycin; ampullary carcinoma; hepatic intra-arterial chemotherapy; liver metastases

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