• Shiori Yamazaki, Koji Kubota, Akira Shimizu, Tsuyoshi Notake, Kentaro Umemura, Atsushi Kamachi, Takamune Goto, Hidenori Tomida, Naho Yamashita, Midori Sato, Hiroyuki Kanno, and Yuji Soejima.
• Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Japan.
• Intern. Med. 2024 Apr 15; 63 (8): 110511121105-1112.

AbstractCholangiocarcinoma has a poor prognosis, and resection is the only curative treatment. Pembrolizumab, a programmed death receptor 1 inhibitor, has proven effective against unresectable or metastatic solid tumors with high microsatellite instability (MSI-H) or a high tumor mutation burden (TMB-H). In the present case, pembrolizumab treatment was initiated after standard chemotherapy for MSI-H and TMB-H unresectable intrahepatic cholangiocarcinoma. Intrahepatic tumor necrosis perforated the abdominal cavity. Emergency surgery was performed, but the patient died 36 days after admission. A pathological autopsy revealed that the intrahepatic tumor had almost completely disappeared.

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