CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(11): E1713-E1716
DOI: 10.1055/a-1236-3105
Innovation forum

Endoscopic ultrasound-guided radiofrequency ablation for hepatocellular carcinoma in cirrhosis: a case report test for efficacy and future perspectives

Germana de Nucci
1  Gastroenterology and Digestive Endoscopy Unit, ASST Rhodense, Garbagnate Milanese, Milan, Italy
,
Cristina della Corte
2  Gastroenterology and Digestive Endoscopy Unit, ASST Rhodense, Rho, Milan, Italy
,
Raffaella Reati
1  Gastroenterology and Digestive Endoscopy Unit, ASST Rhodense, Garbagnate Milanese, Milan, Italy
,
Nicola Imperatore
3  Gastroenterology and Digestive Endoscopy Unit, AORN Cardarelli, Naples, Italy
,
Ilaria Arena
2  Gastroenterology and Digestive Endoscopy Unit, ASST Rhodense, Rho, Milan, Italy
,
Alberto Larghi
4  Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, Rome, Italy
,
Gianpiero Manes
1  Gastroenterology and Digestive Endoscopy Unit, ASST Rhodense, Garbagnate Milanese, Milan, Italy
2  Gastroenterology and Digestive Endoscopy Unit, ASST Rhodense, Rho, Milan, Italy
› Author Affiliations
  

Abstract

Background The percutaneous approach allows for effective and safe treatment of liver lesions. But in case of subcapsular or left segments location, this approach seems to be less effective or unsafe. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is a new technique used to treat pancreatic and neuroendocrine tumors in patients unfit for surgery.

Methods Hereby, we describe the case of a 70-year-old patient with cirrhosis with a large subcapsular hepatocellular carcinoma (HCC) in II-III-IVb segments, in which surgery or percutaneous therapies were not feasible, treated with EUS-RFA. The HCC was treated using an EUS-RFA (EUSRA) system, which consists of a 19G water-cooled monopolar RFA needle and a dedicated generator system.

Results After a multidisciplinary discussion, the lesion was ablated in two different sessions, which resulted in destruction of about 70 % of neoplastic tissue. A second step surgery was required but initially refused by the patient.

Conclusions EUS-RFA could be an effective way to treat left hepatic lesions not manageable with conventional percutaneous methods. This case report does not highlight concerns about safety of this approach and this observation needs to be validated in a larger cohort of patients with cirrhosis.



Publication History

Received: 27 April 2020

Accepted: 15 July 2020

Publication Date:
22 October 2020 (online)

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany