Successful resection of hepatocellular carcinoma with bronchobiliary fistula caused by repeated transcatheter arterial embolizations: Report of a case.
Bronchobiliary fistula (BBF) is a rare but life-threatening condition. We herein describe a rescued case of a patient with hepatocellular carcinoma (HCC) who developed BBF as a late complication of transcatheter arterial embolization (TAE). A 66-year-old man underwent repeated TAE for a large HCC during a 3-year period. Massive biliptysis developed after the last treatment and bronchoscopy proved the presence of BBF. Radiological studies exhibited a necrotic HCC in the right liver with a tumor thrombus protruding into the common bile duct. Localized pneumonia was also present in the right lung. A right hemihepatectomy with a bile duct tumor thrombectomy and a right lower lobectomy of the lung were performed. He is presently doing well at 6 months after surgery. Increased intraluminal pressure of the biliary system due to obstruction by the tumor thrombus is considered to have led to the rupture of the liver abscess into the bronchus, thus creating a BBF. This is the first successfully resected case of HCC associated with BBF.
Hibi
Taizo
T
Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Sakamoto
Yoshihiro
Y
Asamura
Hisao
H
Tochigi
Naobumi
N
Ojima
Hidenori
H
Shimada
Kazuaki
K
Sano
Tsuyoshi
T
Kosuge
Tomoo
T
D000368:Aged; D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001983:Bronchial Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D014057:Tomography, X-Ray Computed