Multimodal Therapy including Yttrium-90 Radioembolization as a Bridging Therapy to Liver Transplantation for a Huge and Locally Advanced Intrahepatic Cholangiocarcinoma.
Treatment of intrahepatic cholangiocarcinoma remains a major challenge. For an unresectable lesion without extrahepatic spread, liver transplantation could be a potential solution but it is still associated with poor oncologic results owing to the absence of effective neoadjuvant treatment. We report the case of a young man with locally advanced intrahepatic cholangiocarcinoma presenting with multiple intrahepatic metastases and vascular structure involvement. The lesion was significantly downstaged by a multimodal therapy including intra-arterial Yttrium-90 radioembolization, systemic chemotherapy and external radiotherapy, allowing liver transplantation. Three years after the procedure, oncologic outcome is excellent with no sign of recurrence. Multimodal therapy including Yttrium-90 radioembolization could be relevant as neoadjuvant treatment before liver transplantation for unresectable intrahepatic cholangiocarcinoma.
CHU Rennes, Service de Chirurgie Hépatobiliaire et Digestive;INSERM, U1414, Centre d'Investigation Clinique, Rennes;Université Rennes 1, Faculté de Médecine, France. michel.rayar@chu-rennes.fr.
Michel
M
Rayar
CHU Rennes, Service de Chirurgie Hépatobiliaire et Digestive, Rennes, France.
Giovanni Battista
GB
Levi Sandri
INSERM, U1414, Centre d'Investigation Clinique, Rennes; CHU Rennes, Service des maladies du foie, Rennes, France;
Pauline
P
Houssel-Debry
INSERM, U1414, Centre d'Investigation Clinique, Rennes;CHU Rennes, Réanimation médicale; F-35033 Rennes, France.
Christophe
C
Camus
CHU Rennes, Service de Chirurgie Hépatobiliaire et Digestive;INSERM, U1414, Centre d'Investigation Clinique, Rennes;Université Rennes 1, Faculté de Médecine, France.
Laurent
L
Sulpice
CHU Rennes, Service de Chirurgie Hépatobiliaire et Digestive;INSERM, U1414, Centre d'Investigation Clinique, Rennes;Université Rennes 1, Faculté de Médecine, France.
Karim
K
Boudjema
D000328:Adult; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D004621:Embolization, Therapeutic; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D015021:Yttrium Radioisotopes / Q000008:administration & dosage*
D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes