Metastatic Seeding of Bile Duct Carcinoma in the Transhepatic Catheter Tract: Report of a Case

Abstract

We describe herein the case of a 51-year-old woman in whom metastatic tumor seeding of the percutanenous transhepatic biliary drainage tract occurred following a pancreatoduodenectomy for carcinoma of the distal common bile duct. An abdominal computed tomography scan done 6 months after the initial operation detected a hepatic lesion located at the site of the previous percutaneous transhepatic biliary drainage tract. Implantation of bile duct carcinoma in the drainage tract was diagnosed, and the recurrent tumor was successfully resected by performing a subsegmentectomy of segment 3 and removal of the adjacent abdominal wall. At present, 5 years and 4 months after the second resection, the patient is in good health without any signs of recurrence. This case report demonstrates that an aggressive surgical approach should be performed for tumor seeding of a transhepatic biliary catheter tract.

Percutaneous transhepatic biliary drainage catheter tract recurrence in cholangiocarcinoma

“…Percutaneous transhepatic biliary drainage (PTBD) has been used widely as an established method of treatment of malignant biliary obstruction1–3. Of several kinds of PTBD‐related complication, metastatic tumour seeding along the PTBD sinus tract is reported to be an unusual but serious complication4–22. However, all of the previous studies have been case reports that included either a single case or fewer than four cases.…”

“…Furthermore, a treatment strategy has not yet been established. Several authors have reported that this type of recurrence is either unresectable or only partially resectable4–14, whereas other authors have stressed the clinical benefits of aggressive surgical intervention15–22.…”