English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

of fiducial marker previously placed under endosonographic guidance to assist radiotherapy A 39-year-old woman attended our hospital with jaundice. A computed tomography (CT) scan revealed a low attenuation 3.3×2.0cm mass in the caudate lobe of the liver with left hepatic artery and left portal vein invasion, and bile duct obstruction (●" Fig.1). Endoscopic biliary drainage and endoscopic ultrasound fineneedle aspiration (EUS-FNA) were performed. A biopsy taken from the mass contained adenocarcinoma cells. Because of the unresectability of this cholangiocarcinoma, three fiducial markers were inserted into the tumor under EUS guidance (●" Fig.2). Image-guided radiation therapy was then performed with a 26-Gy dosage delivered in four fractions. The patient also received systemic chemotherapy and photodynamic therapy. After 5 months, a follow-up CT scan showed that the tumor mass in the caudate lobe was markedly smaller. However, thrombosis of left and right (P7) branches of the portal vein was detected. No definite migration of any fiducial marker was seen. A further 6 months after image-guided radiation therapy, the patient was again admitted with a fever. A CT scan revealed a hepatic infarction at S6 because of right portal vein occlusion resulting from migration of a fiducial marker to the right portal vein (●" Fig.3). The patient then underwent percutaneous drainage with antimicrobial therapy and recovered with no further adverse events. EUS-guided fiducial placement for abdominal malignancies has been reported to be safe and technically feasible [1,2]. Fig.1 A computed tomography (CT) scan from a 39-year-old woman with jaundice revealed a low attenuation 3.3×2.0cm caudate mass with left hepatic artery and left portal vein invasion, and bile duct obstruction.

Hepatic infarction caused by vascular migration of fiducial marker previously placed under endosonographic guidance to assist radiotherapy