Effect of S-1 in a patient with post-operative recurrence of carcinoma of the ampulla of Vater

We report a case of recurrent carcinoma of the ampulla of Vater with multiple lung and abdominal lymph node metastases that well responded to S-1, an oral fluoropyrimidine. A 56-years-old woman underwent a pylorus-preserving pancreaticoduodenectomy for carcinoma of the ampulla of Vater in October 2003. Multiple lung metastases were detected by chest X-ray as a post operative screening a year after surgery. Computed tomography showed multiple abdominal lymph node metastases. The patient was treated with S-1 (80 mg/day, day 1-28, followed by 2 weeks rest) from November 2003. Anti-tumor efficacy was confirmed to be partial response by Response Evaluation Criteria in Solid Tumors (RECIST). Leukocytopenia, anemia, and mucositis were observed. Every toxicity was mild to moderate, and no other severe toxicities were noted. S-1 might be an effective and safe agent for carcinoma of the ampulla of Vater.