High-dose-rate brachytherapy of recurrent rectal adenocarcinoma presenting as a solitary intravascular metastasis of the iliac vein: a case report.
OBJECTIVE
To describe a novel use of high-dose-rate intravascular brachytherapy in the first reported case of macroscopic metastatic rectal adenocarcinoma within a peripheral vein.


METHODS
Following thrombolytic therapy to ablate an overlying venous thrombosis, a vascular stent was deployed across the entire length of the tumor. Using the stent as a target, 4300 cGy was delivered to the tumor via megavoltage external beam radiation. This was followed by two weekly intravascular high-dose-rate 192Ir brachytherapy applications of 400 cGy each.


RESULTS
There is no evidence of recurrence in the treated vein at 43 months of follow-up.


CONCLUSIONS
In this unique case, a combination of external beam radiation therapy and intravascular brachytherapy provided effective control of a solitary intravascular metastasis from rectal carcinoma.
Mendoza
April S
AS
Department of Radiation Oncology, Eastern Virginia Medical School, Norfolk, VA 23507-1999, USA.
Shaves
Mark E
ME
D000230:Adenocarcinoma / Q000150:complications / Q000556:secondary* / Q000628:therapy*; D001918:Brachytherapy; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000473:pathology*; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D009360:Neoplastic Cells, Circulating; D011859:Radiography; D012004:Rectal Neoplasms / Q000473:pathology* / Q000628:therapy; D015607:Stents; D014463:Ultrasonography; D019043:Vascular Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000556:secondary*; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy