The authors present a case of a patient with rectal adenocarcinoma and lung metastasis undergoing elective radiofrequency (RF) ablation of a large, refractory pulmonary metastasis. The mass was located in the left upper lobe, invading the left hilum. The patient experienced shortness of breath following the procedure and shortly after extubation. This shortness of breath progressed over 4 days, when the patient developed acute respiratory distress syndrome (ARDS). The patient suffered from complications related to respiratory support and expired 9 days after RF ablation. Possible mechanisms of ARDS development following pulmonary ablation are discussed.
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