title: Gamma knife-treated hepatoma: case of obstructive jaundice and management.
abstract: Gamma knife therapy is becoming more frequently applied in solid tumor treatment. This article reports a unique case of severe obstructive jaundice arising as a complication of treatment of hepatoma at the hepatic hilum using a gamma knife.While planning an intervention, some images seem to promise success but actually lead to failure. Radiation damage to specific organs is difficult to predict because of several variables. Radiation-induced fibrosis and necrosis are the most common long-term adverse effects of radiotherapy; they are usually considered irreversible and result in induration and firmness of the tissue.To minimize radiation fibrosis, accurate patient positioning and tumor relocalization are essential for gamma knife use in the liver and other extracranial sites. Even when practiced frequently, any intervention must be delivered with caution if the liver has been treated with radiation. Otherwise, even with much experience, the unwary doctor can be trapped by deceptive images.
authors.affiliation: West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
authors.forename: Ming-Quan
authors.initials: MQ
authors.lastname: Wang
authors.forename: Qing
authors.initials: Q
authors.lastname: Zou
authors.forename: Qing
authors.initials: Q
authors.lastname: He
authors.forename: Yong-Song
authors.initials: YS
authors.lastname: Guan
mesh_terms: D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000532:radiotherapy*; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000532:radiotherapy*; D002758:Cholangiography; D049448:Cholangiopancreatography, Magnetic Resonance; D019299:Decompression, Surgical; D004322:Drainage; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D008111:Liver Function Tests; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D016634:Radiosurgery / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed