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An astroblastoma is a rare primary glial tumour occurring preferentially in young adults. It is characterised by a perivascular arrangement of tumour cells forming perivascular pseudorosettes mimicking ependymomas. The histogenesis of astroblastoma is unclear.
We present the history of a 13-year-old girl with chief complaints of headache associated with vomiting, blurring of vision on the left eye and a history of diplopia on the right eye. She underwent left parietal parasagittal craniotomy and near-total excision of tumour. She was planned for postoperative radiotherapy 5,940 cGy in 28 fractions along with concurrent temozolamide100 mg. She had no neurological deficit or complaints during her last visit.
Astroblastomas are a distinct clinic pathologic entity, with well-described radiologic, pathologic and cytogenetic features. Its recurrence is high, and efforts must be made to elucidate the role and usefulness of radiotherapy and chemotherapy in these tumours.
Cholangiocarcinoma (CCA) or klatskin’s tumour involves malignant tumours at the liver hilum’s biliary confluence. Incidence of CCA results in unresectable tumours that require appropriate therapy to improve quality of life. The liver is considered as the most frequent site of tumour recurrence. Promising results of long-term survival have been established with computed tomography-guided high-dose-rate brachytherapy.
Materials and methods:
Intraluminal brachytherapy (ILBT) is performed through the percutaneous transhapatic bile duct drain tube (PTBD). The passage of the brachytherapy guide tube through the bile duct is more complex compared with oesophageal/endobronchial application.
It results in a recoiled view of the tube in the abdominal region of the computed tomography (CT) scan. Owing to inherent artefacts induced by metal stents in CT scans, intersected view is possible between the ILBT guide tube and the intra-hepatic drain tube. It would mislead the planner to track wrong passage that could result in fatal error.
In this case study, we contoured the ILBT guide tube by cross-verifying its position with a digitally reconstructed radiograph (DRR) before catheter tracking. Thus, it ensures precise simulation of source dwell positions, thereby avoiding high-dose delivery to nearby vital organs such as intestines, liver hilum and blood vessels.
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