A CASE OF CHOLANGIOCARCINOMA APPESRED THROUGH 45-YEAR PERIOD AFTER THROTRUST INFUSION

Abstract

A patient with cholangiocarcinoma appeared through a 45-year period after throtrust infusion could survive for a relatively long term with intraarterial infusion chemotherapy.A 67-year-old man received minute exploration for abnormal liver function that was pointed out at another hospital, and a tumor existing in the posterior segment of right lobe of the liver was found. There was a history of fluoroscopic examination of the liver using trotrust during the World War II. On admission abnormally high levels of CA19-9 and DUPAN2 were shown. From preoperative echo-guided puncture, a diagnosis of intrahepatic bile duct carcinoma was made. During operation it was found that the tumor directly invaded the inferior vena cava, right hepatic vein, middle hepatic vein, left hepatic artery, and diaphragm. This case was considered inoperable, and the operation was terminated after an intraarterial pump was inserted into the proper hepatic artery for intraarterial infusion of anticancer agents. Postoperatively intraarterial infusion chemotherapy was started. The patient survived for a relatively long period of one year and 8 months from the tumor confirmation by imagings to the death.There was no unified guideline for the treatment of the disease, however, aggressive intraartrial infusion chemotherapy appears one of the measures providing a life-prolongation effect even for inoperable cases.