Gut Liver.  2010 Sep;4(3):398-401.

Peroral Direct Cholangioscopic-Guided Biopsy and Photodynamic Therapy Using an Ultraslim Upper Endoscope for Recurrent Hepatocellular Carcinoma with Intraductal Tiny Nodular Tumor Growth

• Noh SH
• Park DH
• Kim YR
• Chun YH
• Song TJ
• Moon SH
• Lee SS
• Seo DW
• Lee SK
• Kim MH

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.

Keyword

Peroral direct cholangioscopy; Photodynamic treatment; Recurrent hepatocellular carcinoma; Intraductal growth

MeSH Terms

Biopsy
Carcinoma, Hepatocellular
Cholangiopancreatography, Endoscopic Retrograde
Cholangiopancreatography, Magnetic Resonance
Cicatrix
Constriction, Pathologic
Endoscopes
Female
Humans
Mastectomy, Segmental
Middle Aged
Photochemotherapy
Triazenes
Triazenes