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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.
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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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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