BRMS is an uncommon cause of recurrent jaundice and conjugated hyperbilirubinemia in children. Because its presentation may mimic that of a choledochal cyst, the correct diagnosis is frequently made intraoperatively at a planned choledochal cystectomy. However, identification of this entity prior to surgery is important because early surgery may carry excess morbidity and mortality.
An article to be published on August 14, 2008 in the World Journal of Gastroenterology reports this case. The research team led by Ryan W. Himes from Texas Children's Hospital presented a patient with BRMS in whom therapeutic endoscopy was used successfully as an adjunct to chemotherapy and radiotherapy.
Authors presented the case of a 3-year-old with BRMS in whom endoscopic retrograde cholangiopancreatography (ERCP) was successfully used to obtain a tissue specimen for diagnosis and to place a stent to relieve the biliary obstruction while chemotherapeutics were employed, obviating the need for surgery and its attendant risks of morbidity and mortality. The technique allowed them to obtain tissue for diagnostic purposes and to place a biliary stent to relieve obstruction. Standard chemotherapy and radiotherapy regimens were employed to shrink the tumor. The patient is free-of-disease with one year of follow-up. They concluded that ERCP is an effective alternative to surgery for BRMS in some patients.
Reference: Himes RW, Raijman I, Finegold MJ, Russell HV, Fishman DS. Diagnostic and therapeutic role of endoscopic retrograde cholangiopancreatography in briliary rhabdomyosarcoma. World J Gastroenterol 2008; 14(30): 4823-4825
http://www.wjgnet.com/1007-9327/14/4823.asp
Correspondence to: Ryan W Himes, Section of Pediatric Gastroenterology, Hepatology & Nutrition, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin St, CCC 1010.00, Houston, Texas 77030, United States. himes@bcm.tmc.edu
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About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection. It provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the title China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology