Figure 3:

Fifty nine-years old woman with histologically verified peritoneal metastasis of a gallbladder cancer after cholecystectomy.

Postoperative CT-scan showed a residual tumor with central necrosis in the liver hilus (a1) as well as peritoneal metastasis with small nodular diffuse infiltration of fatty tissue (b1). After repeated (e)PIPAC combined with palliative systemic chemotherapy, significant regression of the solid tumor component (a2) and complete regression of the peritoneal metastasis (b2) were documented. Multiple and repeated peritoneal biopsies remained tumor free (complete histological regression, PRGS 1). Patient is alive 22 months after diagnosis and 18 months after first PIPAC.