Hilar cholangiocellular carcinoma (CCC) is a malignant neoplasm of epithelial origin occurring at the confluence of the right and left hepatic bile ducts. Typically, these tumors are small, poorly differentiated, exhibit aggressive biologic behavior with non-specific symptoms and tend to obstruct the intrahepatic bile ducts. Surgery is the only available curative option. Unfortunately, in less than half of the patients a complete resection is possible with poor survival rate in unresectable cases. In this report, we present the case of a 58-year-old woman with a history of unresectable hilar cholangiocarcinoma. Initially she was treated with intraductal dilatation of malignancy and placement of a plastic stent and chemotherapy (Gemcitabin® and Platinol®). Two years later she underwent a second-line chemotherapy with Gemcitabin® and Oxyplatin® because of tumor progression. Despite a second line chemotherapy and placement of an uncovered self-expandible metal stent (ucSEMS) that was extended later on by stent-in stent technique, there was tumor progression which led to a complex course with relapsing obstructive cholangiosepsis and cholestasis. Because of tumor ingrowth, endobiliary radiofrequency ablation of the malignant stenosis was performed in repeated sessions. This case illustrates that radiofrequency ablation of solitary malignant biliary obstruction is feasible, safe and allows an improvement of quality of life in non-operable patients.
Gastrointest Tumors 2022;9:12–18

中文翻译：

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胆内射频消融治疗恶性胆道梗阻超过 32 个月的随访

肝门部胆管细胞癌 (CCC) 是上皮起源的恶性肿瘤，发生在左右肝胆管的汇合处。通常，这些肿瘤很小，分化差，表现出具有非特异性症状的侵袭性生物学行为，并且往往会阻塞肝内胆管。手术是唯一可用的治疗选择。不幸的是，在无法切除的病例中，只有不到一半的患者可以完全切除，但存活率很低。在本报告中，我们介绍了一名 58 岁女性的病例，她有无法切除的肝门部胆管癌病史。最初，她接受了恶性肿瘤导管内扩张术、塑料支架置入术和化疗（Gemcitabin® 和 Platinol®）治疗。两年后，由于肿瘤进展，她接受了 Gemcitabin® 和 Oxyplatin® 的二线化疗。尽管进行了二线化疗并放置了未覆盖的自膨胀金属支架 (ucSEMS)，随后通过支架内支架技术进行了延长，但肿瘤进展导致了复发性阻塞性胆管败血症和胆汁淤积的复杂病程。由于肿瘤向内生长，恶性狭窄的胆内射频消融术重复进行。该病例说明射频消融治疗孤立性恶性胆道梗阻是可行、安全的，并且可以改善不能手术患者的生活质量。尽管进行了二线化疗并放置了未覆盖的自膨胀金属支架 (ucSEMS)，随后通过支架内支架技术进行了延长，但肿瘤进展导致了复发性阻塞性胆管败血症和胆汁淤积的复杂病程。由于肿瘤向内生长，恶性狭窄的胆内射频消融术重复进行。该病例说明射频消融治疗孤立性恶性胆道梗阻是可行、安全的，并且可以改善不能手术患者的生活质量。尽管进行了二线化疗并放置了未覆盖的自膨胀金属支架 (ucSEMS)，随后通过支架内支架技术进行了延长，但肿瘤进展导致了复发性阻塞性胆管败血症和胆汁淤积的复杂病程。由于肿瘤向内生长，恶性狭窄的胆内射频消融术重复进行。该病例说明射频消融孤立性恶性胆道梗阻是可行的、安全的，并且可以改善不能手术患者的生活质量。
胃肠道肿瘤 2022；9:12–18