Talukder Shibojit, Behera Arunanshu, Tandup Cherring, Mitra Suvradeep
Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
BMJ Case Rep. 2017 Apr 18;2017:bcr-2017-219864. doi: 10.1136/bcr-2017-219864.
Percutaneous transhepatic biliary drainage (PTBD) catheter site metastasis in cases of cholangiocarcinoma is reported sporadically. But it is unusual to see left-sided tumour metastasising to the right PTBD catheter site. Metastasis, in general, has a poor prognosis, but recurrence along the catheter tract in the absence of other systemic diseases can be a different scenario altogether. To date, there is no consensus on the management of this form of metastasis. But carefully selected patients can benefit from aggressive surgical resection. We report a case of a young patient with isolated chest wall metastasis 1 year after resection of left-sided hilar cholangiocarcinoma. The metastasis was resected and, on pathological analysis, was confirmed to be due to implantation of malignant cells along the tract of the PTBD catheter placed via a transpleural route.
胆管癌患者经皮肝穿刺胆道引流（PTBD）导管部位转移的报道较为零散。但左侧肿瘤转移至右侧PTBD导管部位的情况并不常见。一般来说，转移预后较差，但在没有其他全身性疾病的情况下，沿导管 tract 复发则是完全不同的情况。迄今为止，对于这种转移形式的处理尚无共识。但经过精心挑选的患者可从积极的手术切除中获益。我们报告一例年轻患者，在左侧肝门胆管癌切除术后1年出现孤立性胸壁转移。转移灶被切除，经病理分析证实是由于经胸膜途径放置的PTBD导管 tract 上植入了恶性细胞所致。
