Peroral Direct Cholangioscopic-Guided Biopsy and Photodynamic Therapy Using an Ultraslim Upper Endoscope for Recurrent Hepatocellular Carcinoma with Intraductal Tiny Nodular Tumor Growth.
- Author:
Se Hui NOH
1
;
Do Hyun PARK
;
Yi Rang KIM
;
Yoon Hee CHUN
;
Tae Jun SONG
;
Sung Hoon MOON
;
Sang Soo LEE
;
Dong Wan SEO
;
Sung Koo LEE
;
Myung Hwan KIM
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. dhpark@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Peroral direct cholangioscopy;
Photodynamic treatment;
Recurrent hepatocellular carcinoma;
Intraductal growth
- MeSH:
Biopsy;
Carcinoma, Hepatocellular;
Cholangiopancreatography, Endoscopic Retrograde;
Cholangiopancreatography, Magnetic Resonance;
Cicatrix;
Constriction, Pathologic;
Endoscopes;
Female;
Humans;
Mastectomy, Segmental;
Middle Aged;
Photochemotherapy;
Triazenes
- From:Gut and Liver
2010;4(3):398-401
- CountryRepublic of Korea
- Language:English
-
Abstract:
Bile-duct invasion is rare in patients with hepatocellular carcinoma (HCC). We report a case that received peroral direct cholangioscopy (PDCS)-guided endoscopic biopsy and photodynamic treatment (PDT) for recurrent HCC with intraductal tiny nodular tumor growth. A 64-year-old woman presented with recurrent right upper-quadrant pain. Six months previously she had been diagnosed with HCC with bile-duct invasion in the right anterior segment and had received right anterior segmentectomy. On pathological examination, the margin of resection was clear, but macroscopic bile-duct invasion was noted. On admission, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP) revealed a 0.5-cm-sized polypoid mass at the hilar portion. ERCP-guided biopsy failed, and an ampullary stricture was noted. PDCS-guided endoscopic biopsy was thus performed, and histopathology of the retrieved specimen revealed HCC. The patient submitted to PDT. There was no procedure-related complication. After 1 month of PDT the polypoid lesion and scar change at the hilar lesion had disappeared.
