Six-year recurrence free survival after intraluminal iridium-192 therapy of human bilobar biliary papillomatosis : A case report

Biliary papillomatosis is rare and often fatal. Liver resection or transplantation is recommended but may be impossible due to tumor or patient factors; furthermore, it appears to the authors of this study that no follow-up results after transplantation have been reported in previous studies. Biloba...

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Bibliographic Details
Published in:Cancer 2000-07, Vol.89 (1), p.69-73
Main Authors: GUNVEN, P, GORSETMAN, J, OHLSEN, H, RUDEN, B.-I, LUNDELL, G, SKOOG, L
Format: Article
Language:English
Subjects:
Bile Duct Neoplasms - pathology
Bile Duct Neoplasms - radiotherapy
Biological and medical sciences
Brachytherapy - methods
Disease-Free Survival
Diseases of the digestive system
Electrocoagulation
Humans
Iridium Radioisotopes - therapeutic use
Male
Medical sciences
Middle Aged
Papilloma - pathology
Papilloma - radiotherapy
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
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Summary:Biliary papillomatosis is rare and often fatal. Liver resection or transplantation is recommended but may be impossible due to tumor or patient factors; furthermore, it appears to the authors of this study that no follow-up results after transplantation have been reported in previous studies. Bilobar but limited biliary papillomatosis in a man age 54 years was mapped by cholangiopancreatography, cholecystectomy, and operative cholangioscopy. After cholangioscopic electrocoagulation, iridium-192 wires were temporarily inserted into the affected bile ducts, giving a dose of 60 grays at a 3-mm distance. Another percutaneous cholangioscopic electrocoagulation was performed 3 weeks later. The patient has been free of tumor and in good health for 80 months, but he has a long term stenting of a nonneoplastic stricture at the confluence of the bile ducts. Mechanical tumor reduction and intraluminal brachytherapy could possibly replace transplantation (which up to now has been suggested but not reported) when this life-threatening disease is bilobar, and also possibly replace liver resection for limited tumors in patients who are too frail for surgery.
ISSN:0008-543X
1097-0142
DOI:10.1002/1097-0142(20000701)89:1<69::AID-CNCR10>3.0.CO;2-9