Clin Endosc.  2016 Sep;49(5):479-482. 10.5946/ce.2015.149.

Long-Term Palliative Effect of Stenting in Gastric Outlet Obstruction Due to Transarterial Chemoembolization with Yttrium-90 in a Patient with Metastatic Neuroendocrine Tumor

• Caglar E
• DoÄŸusoy G
• Kabasakal
• Dobrucali

• KMID: 2356057
• DOI: http://doi.org/10.5946/ce.2015.149

Abstract

Internal radioembolization with yttrium-90 is a promising treatment method, predominantly for liver tumors. However, the shifting of yttrium-90-loaded spherules into the arteries and veins that supply the duodenum and stomach, leading to ulceration, hemorrhage, perforation, and outlet obstruction of these organs, is one of the major undesirable consequences of this technique. We report a case of gastric outlet obstruction (GOO) due to antropyloric stenosis with ulceration, edema, and inflammation following transarterial yttrium-90 treatment for a metastatic neuroendocrine tumor in a 58-year-old man. Stenting was used for palliation in this case. GOO improved after stenting and recovery of oral intake was permanent after stent removal.

Keyword

Gastric outlet obstruction; Stenting; Yttrium-90

MeSH Terms

Arteries
Constriction, Pathologic
Duodenum
Edema
Gastric Outlet Obstruction*
Hemorrhage
Humans
Inflammation
Liver
Methods
Middle Aged
Neuroendocrine Tumors*
Stents*
Stomach
Ulcer
Veins

Figure

• 

  Fig. 1. (A) Endoscopy shows gastric ulcer and outlet obstruction (arrow), (B) endoscopic view of balloon dilation (15 mm in diameter). (C) Hanarostent, a partially covered self-expendable metallic stent Duodenum/Pylorus Lasso (NCN; M.I. TECH), (D) proximal view of an opened stent after stenting, and (E) endoscopic view after stent removal.

• 

  Fig. 2. Histological appearance of the biopsy (H&E stain, ×200) showing the presence of yttrium-90 resin microspheres (arrow) in the lamina propria.

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