Reactions 908 - 29 Jun 2002

★ SAntineoplastics

First report of fatal gallbladder carcinoma in anelderly patient: case report

A 67-year-old man developed carcinoma of the gallbladderafter repetitive hepatic arterial chemoembolisation for thetreatment of hepatocellular carcinoma.

The man had received 9 courses of hepatic arterialchemoembolisation [drug and dosage not stated] over a 3-yearperiod when he presented with a 15-day history of progressivejaundice and fever. He had a history of alcohol-relatedcirrhosis and hepatocellular carcinoma in the right lobe of hisliver with atrophy of his left lobe. A cholangiogram revealedlesions of secondary sclerosing cholangitis. Placement of anendoscopic stent was carried out and was partially effective.He then underwent a surgical procedure which involvedhepaticojejunal anastomosis with cholescystectomy.

Pathological examination found transmural fibrosis,thickening and replacement of the man’s gallbladder wall withgranulation tissue. There was adenocarcinoma infiltration ofthe serosa in his gallbladder. He died a few days later fromseptic shock.

Author comment: ‘Our case report provides evidence for adirect link between chronic acalculous cholecystitis and cancer. . . Cholecystectomy has to be discussed in patients treatedwith repetitive courses of HACE [hepatic arterialchemoembolisation].’Balian A, et al. Gallbladder carcinoma secondary to repetitive hepatic arterialchemoembolization. American Journal of Gastroenterology 97: 1079-1080, Apr2002 - France 800908019

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of gallbladder carcinomaassociated with antineoplastic agents. The WHO Adverse DrugReactions database contained 2 reports of bile duct carcinomaassociated with the antineoplastic agent fluorouracil.

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Reactions 29 Jun 2002 No. 9080114-9954/10/0908-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved