title: One case of intrahepatic cholangiocarcinoma amenable to resection after radioembolization.
abstract: We report the case of a 57-year-old man who was diagnosed with a large unresectable cholangiocarcinoma associated with 2 satellite nodules and without clear margins with the right hepatic vein. Despite 4 cycles of GEMOX (stopped due to a hypertransaminasemia believed to be due to gemcitabine) and 4 cycles of FOLFIRINOX, the tumor remained stable and continued to be considered unresectable. Radioembolization (resin microspheres, SIRS-spheres) targeting the left liver (474 MBq) and segment IV (440 MBq) was performed. This injection was very well tolerated, and 4 more cycles of FOLFIRINOX were given while waiting for radioembolization efficacy. On computed tomography scan, a partial response was observed; the tumor was far less hypervascularized, and a margin was observed between the tumor and the right hepatic vein. A left hepatectomy enlarged to segment VIII was performed. On pathological exam, most of the tumor was acellular, with dense fibrosis around visible microspheres. Viable cells were observed only at a distance from beads. Radioembolization can be useful in the treatment of cholangiocarcinoma, allowing in some cases a secondary resection.
authors.affiliation: Cecilia Servajean, Marine Gilabert, Jean-Luc Raoul, Department of Medical Oncology, Paoli-Calmettes Institute, 13273 Marseille, France.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Servajean
authors.affiliation: Cecilia Servajean, Marine Gilabert, Jean-Luc Raoul, Department of Medical Oncology, Paoli-Calmettes Institute, 13273 Marseille, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Gilabert
authors.affiliation: Cecilia Servajean, Marine Gilabert, Jean-Luc Raoul, Department of Medical Oncology, Paoli-Calmettes Institute, 13273 Marseille, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Piana
authors.affiliation: Cecilia Servajean, Marine Gilabert, Jean-Luc Raoul, Department of Medical Oncology, Paoli-Calmettes Institute, 13273 Marseille, France.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Monges
authors.affiliation: Cecilia Servajean, Marine Gilabert, Jean-Luc Raoul, Department of Medical Oncology, Paoli-Calmettes Institute, 13273 Marseille, France.
authors.forename: Jean-Robert
authors.initials: JR
authors.lastname: Delpero
authors.affiliation: Cecilia Servajean, Marine Gilabert, Jean-Luc Raoul, Department of Medical Oncology, Paoli-Calmettes Institute, 13273 Marseille, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Brenot
authors.affiliation: Cecilia Servajean, Marine Gilabert, Jean-Luc Raoul, Department of Medical Oncology, Paoli-Calmettes Institute, 13273 Marseille, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Raoul
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D006498:Hepatectomy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals
keywords: Combined treatments; Intrahepatic cholangiocarcinomal; Radioembolization; Surgery