Complete Regression of 11 Hepatic Metastases in Metastatic Pancreatic Adenosquamous Carcinoma and the Role of GPT in Patient Navigation.

Complete responses in metastatic pancreatic adenosquamous carcinoma (ASCP) are extremely rare and carbohydrate antigen 19-9 (CA 19-9) interpretation is difficult during cholestasis. A 65-year-old man underwent Whipple procedure on 29 May 2025; pathology confirmed ASCP (pT3 pN2, R0). Contrast-enhanced magnetic resonance imaging (MRI) on 26 June 2025 showed 11 liver lesions interpreted as metastases. Treatment with folinic acid, fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) began on 7 July 2025. From cycle 2, high-dose intravenous vitamin C, doxycycline and later azithromycin were added by the patient and author as off-label home measures, without efficacy claims. After three cycles, follow-up MRI showed complete radiological regression of the hepatic lesions; MRI around the sixth cycle confirmed complete radiological response. Chemotherapy stopped after six cycles. In late September 2025, cholestasis and CA 19-9 rise were initially suspected as recurrence; after ursodeoxycholic acid, CA 19-9 decreased and normalized by 10 January 2026. Follow-up MRI on 20 February 2026 showed no visible hepatic lesions.