Defying the Prognostic Odds: A Case Report of Unexpected Complete Remission of Metastatic Ampullary Carcinoma With Palliative Chemotherapy.

IF 0.6 Q4 ONCOLOGY

Case Reports in Oncological Medicine Pub Date : 2025-09-09 eCollection Date: 2025-01-01 DOI:10.1155/crom/7884410

Akil Olliverrie, Joel Gabin Konlack Mekontso, Jingwei Ren, Syed Karim, Imad Karam, Edwin Chiu, Christopher Chum

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Abstract

Metastatic ampullary carcinoma (AC) almost always carries a poor prognosis. We present a remarkable case of a 69-year-old male with Stage IV pancreaticobiliary-type AC who achieved a complete remission after 45 months of palliative modified FOLFIRINOX chemotherapy (5-fluorouracil, oxaliplatin, leucovorin, irinotecan). This unexpected outcome challenges the conventional understanding of the natural history of advanced AC. Furthermore, molecular analysis revealed a pathogenic PALB2 mutation, along with variants of unknown significance in the POLD1 and RAD50 genes, coding for enzymes involved in various deoxyribonucleic acid (DNA) repair pathways. These findings raise questions about their potential influence on treatment response and prognosis. This case underscores the need for further investigation into the role of molecular alterations and personalized approaches in managing advanced AC.

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无视预后的可能性：一例转移性壶腹癌在姑息性化疗下意外完全缓解的病例报告。

转移性壶腹癌（AC）几乎总是预后不良。我们报告了一个值得注意的病例，一位69岁的男性IV期胰胆型AC患者在经过45个月的姑息性改良FOLFIRINOX化疗（5-氟尿嘧啶、奥沙利铂、亚叶酸钙、伊立替康）后完全缓解。这一意想不到的结果挑战了对晚期AC自然史的传统理解。此外，分子分析显示，在编码各种脱氧核糖核酸（DNA）修复途径的酶的POLD1和RAD50基因中，存在致病性PALB2突变以及未知意义的变异。这些发现提出了它们对治疗反应和预后的潜在影响的问题。该病例强调需要进一步研究分子改变和个性化方法在晚期AC治疗中的作用。

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Case Reports in Oncological Medicine ONCOLOGY-

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审稿时长

16 weeks

期刊介绍： Case Reports in Oncological Medicine is a peer-reviewed, Open Access journal that publishes case reports and case series related to breast cancer, lung cancer, gastrointestinal cancer, skin cancer, head and neck cancer, paediatric oncology, neurooncology as well as genitourinary cancer.