CT‐guided percutaneous microwave ablation of adrenal malignant carcinoma

Abstract

BACKGROUND:Microwave ablation has recently been developed as a safe and effective treatment for a variety of tumors. The authors evaluated the safety and efficacy of computed tomography (CT)‐guided percutaneous microwave ablation of adrenal malignant tumors.METHODS:Nine patients between 41 and 83 years of age (average age, 54 years) with adrenal carcinoma (a total of 10 lesions) received CT‐guided percutaneous water‐cooled microwave ablation. The 9 cases included 1 primary adrenocortical carcinoma and 8 metastatic carcinomas (4 from lung cancer, 2 from hepatocellular carcinoma, 1 from intrahepatic cholangiocarcinoma, and 1 from left tibial osteosarcoma). Of the 8 metastatic cases, 7 were unilateral, and 1 was bilateral. All cases were pathologically confirmed by aspiration biopsy or postsurgical biopsy. The tumor diameters ranged from 2.1 cm to 6.1 cm (average, 3.8 cm). The average number of ablation sites was 1.5 sites (1‐3 sites), and the average accumulated ablation time was 7.7 minutes (4‐15 minutes). The procedures were performed using a cooled‐shaft antenna.RESULTS:The patients were followed for 3‐37 months, with an average of 11.3 months. Nine of 10 lesions were completely necrotized after first treatment. The other lesion was completely necrotized after 2 treatments. One of the patients experienced hypertensive crisis during treatment. No patient experienced recurrent tumor at the treated site, and this lack of recurrence indicated effective local control. All patients had progression of metastatic disease at extra‐adrenal sites.CONCLUSIONS:CT‐guided percutaneous water‐cooled microwave ablation is a minimally invasive and effective method for the treatment of adrenal carcinoma. Cancer 2011;. © 2011 American Cancer Society.

Short-Term Outcomes and Safety of Computed Tomography-Guided Percutaneous Microwave Ablation of Solitary Adrenal Metastasis from Lung Cancer: A Multi-Center Retrospective Study

“…For tumors ≤ 3.5 cm, the complete ablation rate was 100%, suggesting that MWA is effective for treating solitary adrenal gland metastases from lung cancer. Li et al (34) and Wang et al (35) have also reported similar results. The present study included four lesions ≥ 5.0 cm.…”

Analgesic Effects of Microwave Ablation of Bone and Soft Tissue Tumors Under Local Anesthesia

“…To date, MWA has been described in the management of liver [17][18][19][20], kidney [21,22], lung [11,23], thyroid [13], lung [11], and adrenal neoplasms [24]. The use of MWA in bone and soft tissue lesion is not well described, and only a few cases have been described in the literature [19,[25][26][27].…”

Interventional radiology of the adrenal glands: current status

“…PA has been reported to manage all major pathologies affecting adrenal glands: nonfunctioning adenoma; functioning adenoma, including cortisol producing adenoma; aldosteronoma; ACC; pheochromocytoma; and metastasis from renal cell cancer, melanoma, and lung and gastrointestinal tumors (29,(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83)(84)(85).…”

“…In Although some authors suggested that the fast increasing of temperature should induce a hypertensive crisis more frequently than RFA, because of a difference in the setting of excessive catecholamine release (70,84,88), available data suggested that the risk with MWA may be lower, because of the shorter overall time needed to treat adrenal lesions. alternating cycles of freezing and thawing cause mechanical stress on the cellular membranes up to cell disruption (67).…”

“…Chemical ablation in the adrenal gland is typically performed using several small (19-22 gauge) needles placed under imaging guidance (67,84,85).…”