Intracholedocal metastatic thrombus of renal adenocarcinoma

The authors report about the intraoperative discovery of a metastatic thrombus in the common bile duct, produced by a right renal adenocarcinoma metastasized in the Vth segment of the liver. As far as the treatment is concerned, in addition to nephrectomy, the use of a simple device allowed intraluminal irradiation with radioiridium. Although this approach is palliative, it resulted from the desire to maintain the patency of the common bile duct by controlling tumor proliferation within the duct. The pathogenesis of this proliferation is discussed. In our opinion, the favorable outcome after 18 months confirms the merits of this therapeutic attitude, which can be used for such tumoral extensions.