Complete Regression of a Solitary Cholangiocarcinoma Brain Metastasis Following Laser Interstitial Thermal Therapy

Case report: immunotherapy successfully treated brain metastasis in intrahepatic cholangiocarcinoma and literature review

“…Compared with the invasive surgical resection strategy, our MDT considered PD1 inhibitor plus targeted drug combination therapy might be the best choice. Solid central nervous system (CNS) metastasis from iCCA is rare, and together with this case, there are currently only 20 cases having been reported in literature (Table 1) (40)(41)(42)(43)(44)(45)(46)(47)(48). The ages of these patients range from 46 to 75 (mean 61.1 years), and the male: female ratio is 1:1.9.…”

Laser Interstitial Thermal Therapy for Posterior Fossa Lesions: A Systematic Review and Analysis of Multi-Institutional Outcomes

“…A total of 150 patients with a mean age of 56.47 years had undergone LITT for posterior fossa tumors between 2014 and 2021 ( Table 1 ) [ 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 23 , 24 , 25 , 26 ]. Of these patients, 76.1% were female and 23.9% were male.…”

“…Morbidity and mortality data could be extracted for 131 of the 150 patients included in this study. Nine deaths (9/131) resulted from disease progression, treatment failure, or metastasis, and no death occurred from LITT treatment [ 11 , 25 ]; 103 patients had no procedural complications and showed stabilization of disease at the time of last follow-up, which ranged from 2 to 24 months [ 11 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 23 , 25 ]; and 19 patients developed intra- or postoperative complications, including transient and permanent neurologic deficits [ 11 , 12 , 14 , 21 , 23 , 25 ]. Procedure-related complications, usually including new neurologic deficits, occurred in approximately 14.5% (19/131) of the pooled sample.…”

“…Among them, Tan et al [ 18 ], Chan et al [ 19 ], Eliyas et al [ 20 ], Kozlowski et al [ 22 ], and Lawrence et al [ 21 ] each reported only 1 patient who underwent LITT for their posterior fossa lesions, which primarily originated from unresectable intrahepatic cholangiocarcinoma [ 18 ], anaplastic astrocytoma [ 19 ], pulmonary adenocarcinoma with recurrent metastasis [ 20 ], poorly differentiated carcinoma consistent with gastrointestinal versus pulmonary metastasis [ 22 ], and hemorrhagic pontine cavernoma [ 21 ], respectively. With the exception of the last case, which developed diplopia secondary to Abducens’ palsy [ 21 ], none of the aforementioned studies developed post-LITT complications [ 18 , 19 , 20 ]. Gamboa et al reported MR-thermography-guided LITT for 2 brainstem cavernous malformations [ 17 ].…”

Laser interstitial thermal therapy for brain metastases

“… 29 , 46 Lastly, a case report by Tan et al describes the use of LITT as first-line treatment for a cholangiocarcinoma brain metastasis in the deep white matter of the cerebellum, chosen for its relative inaccessibility, without recurrence up to 16 months post-treatment. 47 Without discrete data reporting from these cases it is difficult to draw many conclusions, though the sample provides a proof-of-concept for the treatment. At this time the applications of LITT for newly diagnosed brain metastases are limited, however future roles could develop particularly in locations that require radiation dose reduction or for more radioresistant histologies requiring cytoreduction in more difficult to access areas surgically.…”