title: Complete remission by transarterial infusion with cisplatin for recurrent bile duct tumor thrombus of hepatocellular carcinoma: report of a case.
abstract: Bile duct tumor thrombus (BDTT) of a hepatocellular carcinoma (HCC) is a rare entity which was found microscopically in 1 to 9.2% of the resected specimen.A 54-year-old male was found to have a 65-mm hepatocellular carcinoma in segment VI of the liver with a huge intrahepatic bile duct tumor thrombus. As the main trunk of the posterior segment branched from the left bile duct, the BDTT of the posterior branch extended to the common bile duct via the left bile duct. When the posterior segment was resected along with the left lobe, the estimated remnant liver volume was less than 30%. Therefore, the patient underwent extended posterior segmentectomy with choledochotomy and all of the BDTT was removed via the common bile duct.Three months later, his serum bilirubin (6.63 mg/dL) and des-gamma-carboxy prothrombin (410 ng/mL) were re-elevated due to recurrent BDTT. A well-enhanced BDTT was observed by computed tomography (CT) at the left bile duct. Transarterial chemotherapy with cisplatin was scheduled, followed by endoscopic retrograde bile duct drainage. After four sessions of this chemotherapy, the BDTT had vanished and the tumor marker was decreased to within the normal range. The patient was stably treated with this regimen and has remained recurrence-free for five years.
authors.affiliation: Department of Digestive Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Ebara
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Masamichi
authors.initials: M
authors.lastname: Moriguchi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Mitsuka
authors.forename: Tomoya
authors.initials: T
authors.lastname: Funada
authors.forename: Tokio
authors.initials: T
authors.lastname: Higaki
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000627:therapeutic use*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D012074:Remission Induction; D013927:Thrombosis / Q000188:drug therapy* / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin