Haemostatic radiation therapy for a bleeding intraductal papillary neoplasm of the biliary tree

BMJ Case Rep. 2018 Dec 14;11(1):e226237. doi: 10.1136/bcr-2018-226237.

Abstract

Haemostatic radiation was effectively used as a novel rescue therapy in a 60-year-old man who presented with recurrent melaena refractory to all conventional medical and surgical measures. He needed multiple transfusions and was diagnosed to be bleeding from an intraductal papillary biliary neoplasm which was not amenable to surgical resection in view of the background liver disease. He received conventional radiation therapy (RT) of a dose of 3 Gy per fraction for 3 consecutive days after which he stabilised. After cessation of the RT, he did not require transfusion for the next 2 months. His quality of life improved and it gave us time to evaluate for other definitive measures.

Keywords: cirrhosis; radiotherapy; surgical oncology.

Publication types

  • Case Reports

MeSH terms

  • Bile Duct Neoplasms / diagnostic imaging*
  • Bile Duct Neoplasms / physiopathology
  • Bile Duct Neoplasms / radiotherapy
  • Biliary Tract / diagnostic imaging
  • Biliary Tract / pathology*
  • Caroli Disease / complications
  • Caroli Disease / physiopathology
  • Caroli Disease / therapy*
  • Computed Tomography Angiography
  • Hemorrhage / diagnostic imaging*
  • Hemorrhage / radiotherapy
  • Hemostatics
  • Humans
  • Male
  • Melena / diagnostic imaging*
  • Melena / etiology
  • Middle Aged
  • Quality of Life
  • Radiotherapy, Image-Guided* / methods
  • Treatment Outcome

Substances

  • Hemostatics