Subject(s)
Breast Diseases/diagnosis , Breast Neoplasms/diagnosis , Epithelial Cells/pathology , Aged , Biomarkers, Tumor/analysis , Biopsy, Needle , Breast Diseases/diagnostic imaging , Breast Diseases/metabolism , Breast Diseases/pathology , Breast Diseases/surgery , Breast Neoplasms/chemistry , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Diagnosis, Differential , Epithelial Cells/chemistry , Female , Humans , Immunohistochemistry , Predictive Value of Tests , Ultrasonography, MammaryABSTRACT
We report a case of disseminated recurrence of inferior bile duct carcinoma growing in the fistula where the percutaneous transhepatic cholangiodrainage (PTCD) catheter was instituted. The recurrent tumor seemed to be implanted by dissemination of the original tumor during the first surgery. We could successfully remove this recurring tumor with lateral segmentectomy of the liver plus peritoneal dissection. This patient had been followed after the first surgery (pancreaticoduodenectomy) for inferior bile duct carcinoma causing obstructive jaundice. CEA and CA19-9 raised and CT scan confirmed the recurrent tumor in the lateral segment of the liver. This patient has been in good condition for 2 years following the second surgery.
Subject(s)
Bile Duct Neoplasms/pathology , Biliary Fistula/pathology , Bile Duct Neoplasms/diagnostic imaging , Biomarkers, Tumor , Drainage , Humans , Male , Middle Aged , Secondary Prevention , Tomography, X-Ray Computed , UltrasonographyABSTRACT
BACKGROUND: Prognosis of hepatocellular carcinoma (HCC) with tumor thrombus in the main portal vein (MPV), inferior vena cava (IVC), or extrahepatic bile duct (EBD) treated by conventional therapies has been considered poor. This study aimed to evaluate the efficacy of hepatic arterial infusion chemotherapy after surgical resection as an adjuvant therapy or as a treatment for intrahepatic recurrence of HCC with tumor thrombus in MPV, IVC, or EBD. METHODS: Nineteen patients with HCC and tumor thrombus in the MPV, IVC, or EBD who underwent hepatectomy with thrombectomy were reviewed retrospectively. RESULTS: The overall 3-year survival rate was 48.5%. Two patients with postoperative residual tumor thrombus died within 6 months owing to rapid progression of the residual tumor thrombus. Five patients survived more than 5 years after their operations. Tumors disappeared completely in 3 patients after hepatic arterial infusion chemotherapy with a combination of cisplatinum and 5-fluorouracil, and the longest survival period was 17 years and 11 months in a patient with EBD thrombus. CONCLUSIONS: If hepatic reserve is satisfactory, an aggressive surgical approach combined with chemotherapy seems to be of benefit for patients having HCC with tumor thrombus in the MPV, IVC, or EBD.
