scholarly journals Curative intent radical cholecystectomy followed by hyperthermic intraperitoneal chemotherapy in ruptured intraductal papillary neoplasm of gallbladder with invasive carcinoma

Author(s):  
Gyeonggyu Choi ◽  
Seokwon Jang ◽  
Munseok Choi ◽  
Seungyoon Yang ◽  
Chunggeun Lee ◽  
...  
2017 ◽  
Vol 102 (1-2) ◽  
pp. 70-76
Author(s):  
Ryo Ashida ◽  
Teiichi Sugiura ◽  
Yukiyasu Okamura ◽  
Takaaki Ito ◽  
Keiko Sasaki ◽  
...  

Although there have been many previous studies of IgG4-related SC focusing on the differential diagnosis from cholangiocarcinoma, only a few patients with cholangiocarcinoma against a background of IgG4-related SC have been reported. We herein present a case of intraductal papillary neoplasm of the bile duct (IPNB) associated with invasive carcinoma complicating IgG4-related sclerosing cholangitis. A 71-year-old female with icterus was admitted to a local hospital, where stricture of the extrahepatic bile duct were detected, and subsequently referred to our hospital for possible surgery. Abdominal multidetector-row computed tomography demonstrated marked wall thickening along the entire extrahepatic bile duct. The left lateral superior bile duct (B2) and left lateral inferior duct (B3) were individually obstructed, and percutaneous transhepatic biliary drainage catheters were placed in B2 and B3 separately. The patient was diagnosed to have diffusely spread cholangiocarcinoma and underwent right hepatic trisectionectomy with caudate lobectomy and pancreatoduodenectomy. A histological examination revealed intraductal papillary tumors composed of fibrovascular stalks covered by neoplastic epithelium. Carcinomatous invasion of the papillary tumors was observed in the fibromuscular layer, and there was abundant infiltration of inflammatory cells with fibrosis outside of the cancerous tissue. The inflammatory cells were primarily composed of plasma cells, a majority of which were positive for IgG4 (>30 cells/high-power field); the postoperative serum IgG4 level was 890 mg/dL. Therefore, a diagnosis of coexisting IPNB associated with invasive carcinoma and IgG4-related sclerosing cholangitis was made. To the best of our knowledge, this is the first report of IPNB complicating IgG4-related sclerosing cholangitis.


2022 ◽  
Vol 15 (1) ◽  
pp. e245918
Author(s):  
Tetsuro Takasaki ◽  
Takashi Sakamoto ◽  
Akira Saito ◽  
Yasuaki Motomura

An 82-year-old man presented to the emergency department with abdominal pain and febrile symptoms that had been present for 4 days. Blood tests showed elevated liver enzymes and white blood cell count, and abdominal contrast-enhanced CT revealed a 35 mm cystic lesion in the left lateral liver lobe. On closer examination, the cystic lesion was found to have contiguous bile duct dilatation and internal nodules. Furthermore, mucus production was observed during endoscopic retrograde cholangiopancreatography, which led to the diagnosis of intraductal papillary neoplasm of the bile duct (IPNB), with cystic infection. Although the patient was an older adult, there was no background disease that would have prevented surgery, and resection was performed. Pathological examination revealed type 1 IPNB, with invasive carcinoma. The number of reports of IPNB is expected to increase with an increasing older population in Asia, and we report the findings of this case.


2017 ◽  
Vol 78 (12) ◽  
pp. 2729-2735
Author(s):  
Tomohiro OOKURA ◽  
Takefumi NIGUMA ◽  
Toru KOJIMA ◽  
Nobuyuki WATANABE ◽  
Tetsushige MIMURA

Cancers ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 78 ◽  
Author(s):  
Roxan Helderman ◽  
Daan Löke ◽  
H. Kok ◽  
Arlene Oei ◽  
Pieter Tanis ◽  
...  

Peritoneal metastasis (PM) originating from gastrointestinal and gynecological malignancies are associated with a poor prognosis and rapid disease progression. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective treatment option with curative intent. Hyperthermia enhances the cytotoxicity of chemotherapeutic drugs, thereby killing microscopic tumors and reducing the risk of tumor recurrence. Eight parameters potentially have an impact on the efficacy of HIPEC: the type of drug, drug concentrations, carrier solution, volume of the perfusate, temperature of the perfusate, duration of the treatment, the technique of delivery, and patient selection. In this review, a literature search was performed on PubMed, and a total of 564 articles were screened of which 168 articles were included. Although HIPEC is a successful treatment, there is no standardized method for delivering HIPEC: the choice of parameters is presently largely determined by institutional preferences. We discuss the current choice of the parameters and hypothesize about improvements toward uniform standardization. Quantifying the effect of each parameter separately is necessary to determine the optimal way to perform HIPEC procedures. In vivo, in vitro, in silico, and other experimental studies should shed light on the role of each of the eight parameters.


2019 ◽  
Vol 70 (4) ◽  
pp. 692-699 ◽  
Author(s):  
Sunyoung Lee ◽  
Myeong-Jin Kim ◽  
Sohee Kim ◽  
Dongil Choi ◽  
Kee-Taek Jang ◽  
...  

2021 ◽  
Author(s):  
Eisuke Mukaida ◽  
Akio Tamura ◽  
Kunihiro Yoshioka ◽  
Masao Nishiya ◽  
Tamotsu Sugai

In this report, we present a 57-year-old female with a history of mild alcoholic liver disease during a medical check-up. Abdominal computed tomography and magnetic resonance imaging showed a multicystic mass with a solid enhancing mural nodule in the right lobe of the liver. Subsequently, laparoscopic right liver lobectomy was performed and pathological findings revealed intraductal papillary neoplasm of the bile duct (IPNB) with an associated invasive carcinoma. IPNB is a relatively rare disease that should be considered in the differential diagnosis of hepatic cystic tumours. Our case report highlights the importance of capturing image findings of the IPNB as this disease has a high potential for malignancy.


2016 ◽  
Vol 26 (5) ◽  
pp. 88-92
Author(s):  
Algirdas Šlepavičius ◽  
Vaidotas Turskis ◽  
Vitalija Nutautienė ◽  
Vitalijus Eismontas

Background. Appendiceal peritoneal pseudomyxoma (PMP) is very rare disease and its longterm prognosis is poor. The aim of this study was to evaluate the results of an aggressive treatment approach used in our institution for the last 4 years. Methods. We selected all patients with PMP from appendiceal origin who were treated by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) at the Klaipeda University Hospital between January 2012 and January 2016. Data from all patients with PMP arising from the appendix were retrospectively collected and analyzed. Treatment consisted of complete surgical cytoreduction , followed by hyperthermic intraperitoneal chemotherapy with mitomycin at 42°C over 90 minutes. Ronnett’s hystologic classification was used for tumor grading. Results. A total of 6 patients underwent cytoreduction and peritonectomy plus HIPEC. Median age at diagnosis was 57 years (range, 39-67). All our patients were female. The previous surgery score at the moment of admission was PSS-2 for three patients, PSS-3 for 3 patients. Four patients were diagnosed as diffuse peritoneal adenomucinosis (DRAM) and two as peritoneal mucinous carcinomatosis( PMCA). In all of the patients, optimal cytoreduction CC-0 (5 patients) and CC-1 (one patient) was achieved. The median peritoneal cancer index (PCI) was 17 (range, 14-25) as an indicator of disease extension.The median number of visceral resections performed per patient was 3 (range, 1-5). The median duration of CRS/HIPEC was 8 hours and 10 minutes (range, 7 hours and10 min. to 9 hours 20 min). Mean postoperative stay was 13 days (range, 8-18). The 30 days postoperative and in-hospital mortality were zero . One patient experienced temporary haemorhagic cystitis. The mean follow-up period was 28 months ( range, 8-45). At the time of analysis all patients are alive and without recurrence. Conclusions PMP from appendiceal origin can be treated with curative intent in a large percentage of cases by cytoreductive surgery associated with HIPEC. This new approach could be performed safely with acceptable morbidity and mortality in selected patients treated in specialized centers.


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