1/4. Recurrent thrombo-embolic episodes: the association of cholangiocarcinoma with antiphospholipid syndrome.antiphospholipid syndrome is a disorder of recurrent vascular thrombosis, pregnancy loss and thrombocytopenia associated with persistently elevated levels of antiphospholipid antibodies. It was first described in a group of patients with systemic lupus erythematosus but has since been associated with a wide range of conditions, including other autoimmune disorders and malignancy. It can also occur in isolation, the so-called primary antiphospholipid syndrome. We describe an elderly woman with the antiphospholipid syndrome thought to be associated with a cholangiocarcinoma.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/4. Importance of the detection method for intact dimeric human chorionic gonadotropin without interference with the free human chorionic gonadotropin beta subunit for pregnancy exclusion before liver transplantation in a woman with cholangiocarcinoma.Assay of human chorionic gonadotropin (hCG) is mainly used for the detection and monitoring of pregnancy, and for the follow-up of trophoblastic tumors. The serum free beta-hCG subunit (hCGbeta) is also a tumor marker in many non-trophoblastic tumors, including gastrointestinal cancers. In this work, we compared the performance of several immunoassays for pregnancy exclusion before liver transplantation and in the follow-up of a woman with cholangiocarcinoma. serum hCG was detected with the Abbott Testpack plus hCG-Combo and measured with four automated sandwich immunoassays: ADVIA-Centaur, ACS:180, AxSYM and Dimension. hCGbeta was determined by an automated fluorescence sandwich immunoassay (Kryptor-Free beta hCG) and with a specific immunoradiometric assay (ELSA-F beta hCG, Schering). The expression of hCG was also evaluated by immunohistochemistry on sections of intrahepatic cholangiocarcinoma cells and on peritoneal metastases. Before transplantation, discordant results were observed for pregnancy exclusion. Qualitative Testpack and Dimension tests detected no hCG-like immunoreactivity, whereas the ADVIA-Centaur, ACS:180 and AxSYM tests revealed positive levels. The same discrepancy was obtained in follow-up of the patient after liver transplantation. hCGbeta assay and immunohistochemical staining revealed tumor cell secretion of hCGbeta. In conclusion, a specific serum immunoassay for intact dimeric hCG without cross-reaction with hCGbeta should be adopted as routine policy for pregnancy exclusion before liver transplantation.- - - - - - - - - - ranking = 8keywords = pregnancy (Clic here for more details about this article) |
3/4. A young female with a cholangiocarcinoma in the past: is pregnancy allowed?BACKGROUND: A 28-year-old woman developed a cholangiocarcinoma after using oral contraceptives for eight years. The common bile duct and the gallbladder were removed and four hepaticojejunostomies were performed. RESULTS: Seven years after surgery no evidence of disease recurrence is detectable and the patient wants advice regarding her wish for pregnancy. CONCLUSION: The possible role of oestrogens in the development of cholangiocarcinoma makes it difficult to give an adequate advice. As in patients with breast cancer in the past, it seems reasonable to admit pregnancy in our patient, because of a disease-free interval of longer than five years.- - - - - - - - - - ranking = 6keywords = pregnancy (Clic here for more details about this article) |
4/4. Intrahepatic cholangiocarcinoma masquerading as the hellp syndrome (hemolysis, elevated liver enzymes, and low platelet count) in pregnancy: case report.A young woman was seen at 26 weeks' gestation with a clinical profile consistent with the hellp syndrome (hemolysis, elevated liver enzymes, and low platelet count). The patient underwent cesarean delivery and was found to have a massive tumor involving the liver. After correction of the coagulopathy, a liver biopsy specimen demonstrated an intrahepatic cholangiocarcinoma. The patient died 3 weeks after diagnosis.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |