Needle Tract Seeding after Percutaneous Cryoablation of a Metastatic Hepatic Tumor from Renal Cell Carcinoma: A Case Report

Abstract

A 61-year-old woman with renal cancer underwent percutaneous cryoablation (PCA) for a metastatic hepatic tumor. Because the tumor was subcapsular and 3.6 cm in diameter, we performed transcatheter arterial embolization before PCA. Three cryoprobes were placed in triangular configuration; one inserted with an interposition of the normal hepatic parenchyma at a short distance. Computed tomography (CT) 2 days after PCA showed no contrast enhancement in the ablation zone with adequate ablation margins. CT after 2 months showed small enhancing foci on the hepatic surface. Tumors were located along previously inserted needle track, confirming diagnosis of needle tract seeding. A laparoscopically extirpated specimen revealed clear cell carcinoma, comparable to metastasis from renal cancer. CT after 6 months found additional seeding tumors, and systemic therapy was administered.