Acute Obstructive Cholangitis Complicated by Tumor Migration after Transarterial Chemoembolization: A Case Report and Literature Review / 대한소화기학회지
The Korean Journal of Gastroenterology
;
: 171-175, 2014.
Article
in English
| WPRIM
| ID: wpr-89368
ABSTRACT
Intraductal tumor invasion of hepatocellular carcinoma (HCC) is considered rare. Transarterial chemoembolization (TACE) is effective for tumor thrombus of HCC in the bile duct. However, a few cases of obstructive jaundice caused by migration of a tumor fragment after TACE have recently been reported. The aim of this study was to identify factors that affect tumor migration after TACE. At this writing, a review of the medical literature disclosed seven reported cases of biliary obstruction caused by migration of a necrotic tumor cast after TACE. We, herein, report on an additional case of acute obstructive cholangitis complicated by migration of a necrotic tumor cast after TACE for intrabile duct invasion of HCC, in a 71-year-old man. The tumor cast in the common bile duct was removed successfully using a basket during ERCP and was pathologically confirmed to be a completely necrotic fragment of HCC. The patient's symptoms showed dramatic improvement. In summary, physicians should be aware of acute obstructive cholangitis complicated by tumor migration in a patient undergoing TACE. We suggest that an intrabile duct invasion would be a major predisposing factor of tumor migration after TACE and drainage procedures such as ERCP or percutaneous transbiliary drainage could be effective treatment modalities in these patients.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Thrombosis
/
Bile Ducts, Intrahepatic
/
Tomography, X-Ray Computed
/
Cholangitis
/
Acute Disease
/
Cholangiopancreatography, Endoscopic Retrograde
/
Sphincterotomy, Endoscopic
/
Chemoembolization, Therapeutic
/
Carcinoma, Hepatocellular
/
Jaundice, Obstructive
Type of study:
Prognostic study
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
The Korean Journal of Gastroenterology
Year:
2014
Type:
Article
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