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Long-term percutaneous biliary drainage in an infant with hemangioendothelioma
Insights
A rare pancreatic hemangioendothelioma caused jaundice in an infant. Percutaneous biliary drainage was successfully used for 22 months, leading to tumor regression in this youngest reported patient.
Area of Science:
- Pediatric Surgery
- Interventional Radiology
- Pediatric Oncology
Background:
- A 5-month-old infant presented with jaundice and dilated bile ducts, indicating biliary obstruction.
- Imaging revealed a pancreatic head mass obstructing both cystic and common bile ducts.
Observation:
- The infant underwent cholecystectomy, and tumor biopsy confirmed hemangioendothelioma.
- The tumor obstructed the biliary tree, causing significant jaundice.
Findings:
- Percutaneous biliary drainage was performed to decompress the obstructed biliary tract.
- External drainage was maintained for 22 months, during which the tumor spontaneously regressed.
Implications:
- This case represents the youngest patient to undergo percutaneous biliary drainage for a pancreatic tumor.
- Successful non-operative management and tumor regression highlight a potential therapeutic approach for pediatric hemangioendothelioma.
Abstract:
A 5-month-old female infant with jaundice (bilirubin = 11) and dilated intrahepatic and extrahepatic bile ducts was explored. A 3-cm mass in the head of the pancreas and portal region completely obstructed the cystic and common bile ducts. Cholecystectomy was done and biopsy of the tumor and regional nodes revealed hemangioendothelioma with no nodal involvement. After tissue diagnosis was made, the infant's biliary tract was decompressed percutaneously. External drainage was maintained for 22 months until the tumor regressed. This infant is the youngest patient ever reported to undergo percutaneous biliary drainage.