Vanella G, Coluccio C, Di Giulio E, Assisi D, Lapenta R. Tertiary stent-in-stent for obstructing colorectal cancer: A case report and literature review. World J Gastrointest Endosc 2019; 11(1): 61-67 [PMID: 30705733 DOI: 10.4253/wjge.v11.i1.61]
Corresponding Author of This Article
Emilio Di Giulio, MD, Professor, Department of Digestive Endoscopy, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome 00189, Italy. emilio.digiulio@uniroma1.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jan 16, 2019; 11(1): 61-67 Published online Jan 16, 2019. doi: 10.4253/wjge.v11.i1.61
Tertiary stent-in-stent for obstructing colorectal cancer: A case report and literature review
Giuseppe Vanella, Chiara Coluccio, Emilio Di Giulio, Daniela Assisi, Rocco Lapenta
Giuseppe Vanella, Chiara Coluccio, Emilio Di Giulio, Department of Digestive Endoscopy, Sant’Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy
Daniela Assisi, Rocco Lapenta, Department of Digestive Endoscopy, Regina Elena National Cancer Institute, Rome 00144, Italy
Author contributions: Vanella G, Assisi D and Lapenta R were involved in the procedure and in concept of the report; Vanella G and Coluccio C were involved in retrieving useful information from clinical charts and writing the manuscript; Vanella G, Coluccio C and Di Giulio E were involved in literature review; Di Giulio E, Assisi D and Lapenta R were involved in critical revision of the manuscript; all authors had access and approved the last version of the manuscript.
Informed consent statement: The patient gave informed consent prior to the procedure.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Emilio Di Giulio, MD, Professor, Department of Digestive Endoscopy, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome 00189, Italy. emilio.digiulio@uniroma1.it
Telephone: +39-6-33776151 Fax: +39-6-33776692
Received: October 29, 2018 Peer-review started: October 30, 2018 First decision: November 29, 2018 Revised: December 5, 2018 Accepted: December 13, 2018 Article in press: December 13, 2018 Published online: January 16, 2019 Processing time: 80 Days and 19 Hours
Core Tip
Core tip: Endoscopic positioning of self-expandable metal stents (SEMSs) has an established role in the palliation of obstructing metastatic colorectal cancers (CRCs). More controversial is the management of re-obstruction due to intrastent tumor ingrowth. In our case, a patient with obstructing, metastatic, carcinomatous CRC, primary palliated with SEMS placement, experienced two different episodes of intrastent tumor in-growth. This occurred along with a long-lasting history of partial efficacy of chemotherapy, including bevacizumab. Both these episodes were successfully treated through subsequent stent-in-stent placement, with immediate symptom relief, no procedure-related complications (notwithstanding different negative prognostic factors), no need for chemotherapy discontinuation and, ultimately, a good quality of life.
