J Korean Soc Radiol.  2013 Aug;69(2):143-148. 10.3348/jksr.2013.69.2.143.

Two Cases of Unresectable Cholangiocarcinoma Treated by Yttrium-90 Microspheres

• You SH
• Kim YH
• Cho SB
• Ganbold U
• Um SH
• Seo YS
• Choe JG

• KMID: 2208818
• DOI: http://doi.org/10.3348/jksr.2013.69.2.143

Abstract

Intrahepatic cholangiocarcinoma (ICC) is a rare malignancy and many cases of ICCs are diagnosed in an unresectable state. Until now there has been no effective palliative treatment for these cases. Recently yttrium-90 (90Y) radioembolization has been highlighted as a new palliative treatment for these cases. In Korea, there has been no reported case of unresectable ICC which was treated by 90Y radioembolization up until now. We treated two cases of unresectable ICCs with 90Y radioembolization and the ICCs were necrotized effectively without significant toxicity.

MeSH Terms

Cholangiocarcinoma
Korea
Liver Neoplasms
Microspheres
Palliative Care
Cholangiocarcinoma
Cholangiocarcinoma
Liver Neoplasms

Figure

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  Fig. 1 A 38-year-old man with unresectable intrahepatic cholangiocarcinoma. A. Initial abdominal CT scan (arterial phase) shows 18 cm sized huge mass lesion with peripheral arterial enhancement in both hepatic lobes. B. Technetium 99m macroaggregated albumin scan shows low hepatopulmonary shunt rate (5.87%) and high tumor-to-normal ratio (7.89). C. Celiac arteriography shows hypervascular tumor in both hepatic lobes. D-F. At the 18-month after treatment, size of lesion is reduced (15 cm) and internal necrotic portion is increased. At the 18-month after treatment, previously noted hot-uptake lesion (E) is no more detected in positron emission tomography-CT scan (F).

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  Fig. 2 A 74-year-old man with unresectable cholangiocarcinoma. A. Contrast enhanced CT scan at arterial phase shows 5.5 cm sized intrahepatic cholangiocarcinoma in S1, S7 and S8 before treatment. B. Technetium 99m macroaggregated albumin scan shows low hepatopulmonary shunt rate (4.12%) and high tumor-to-normal ratio (8.08). C. Celiac arteriography shows hypervascular tumor. D-F. At the 25-month after treatment, size of lesion is reduced (3.0 cm) and internal necrosis is noted. At the 25-month after treatment, previously noted hot-uptake lesion (E) is no more detected in positron emission tomography-CT scan (F).

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