Foreign body granuloma reaction following SIRT mimicking peritoneal metastases: a word of caution. Issue 1 (2nd January 2020)

• Record Type: Journal Article
• Authors: Willems, Edward; Smet, Bart; Dedeurwaerdere, Franceska; D'Hondt, Mathieu
• Is Part Of: Acta chirurgica belgica. Volume 120:Issue 1(2020)
• Page Start: 47
• Page End: 49
• Publication Date: 2020-01-02
• Subjects: Intrahepatic cholangiocarcinoma -- selective internal radiation therapy -- SIRT -- peritoneal metastases; Surgery -- Periodicals; General Surgery; Chirurgie -- Périodiques; Surgery; Chirurgie (geneeskunde); Periodicals; Periodicals; 617.005
• DOI: 10.1080/00015458.2018.1494969
• Languages: English
• ISSNs: 0001-5458

Abstract

Abstract: Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver malignancy with poor survival rates. Surgical resection is the only curative treatment option, yet only a small portion of cases are resectable. In unresectable situations, suggested therapy consists of a systemic chemotherapy regimen with cisplatinum and gemcitabine. Selective internal radiation therapy (SIRT) has been proposed as an alternative treatment option and may lead to downstaging of unresectable iCCA to surgery. We present a case of a female patient diagnosed with an unresectable iCCA treated with SIRT in order to obtain downstaging. Explorative laparoscopy three months later showed multiple peritoneal lesions in the left upper quadrant, mimicking peritoneal metastases. Anatomopathological investigation showed a foreign body granuloma surrounding the SIRT resin particles. These findings have important consequences, as the presence of peritoneal metastases implies a palliative situation. Anatomopathological confirmation of any intra-abdominal lesion mimicking peritoneal metastases should be carried out.