ABSTRACT
Radiofrequency ablation (RFA) has become an important tool in the armamentarium of
interventional oncology, particularly in the treatment of primary hepatocellular carcinoma
and metastatic tumors. This procedure has proven to be an effective adjunct in treating
hepatic tumors as a bridge to liver transplantation, and has a low complication profile.
Although adverse events are rare and usually minor, a notable negative outcome is
dissemination and implantation of viable tumor cells into the route of applicator
entry, or tract seeding. Counter to the goal of treating a patient's cancer, this
results in metastatic disease. In this report, the authors present 2 cases of tract
seeding after RFA, methods of detection, and means of reducing the incidence of this
relatively rare, but significant, complication.
KEYWORDS
Percutaneous ablation - tract seeding - radiofrequency ablation (RFA) - hepatocellular
carcinoma (HCC)
REFERENCES
- 1
Chang S, Kim S H, Lim H K et al..
Needle tract implantation after percutaneous interventional procedures in hepatocellular
carcinomas: lessons learned from a 10-year experience.
Korean J Radiol.
2008;
9
(3)
268-274
- 2
Mulier S, Mulier P, Ni Y et al..
Complications of radiofrequency coagulation of liver tumours.
Br J Surg.
2002;
89
(10)
1206-1222
- 3
Espinoza S, Briggs P, Duret J S, Lapeyre M, de Baère T.
Radiofrequency ablation of needle tract seeding in hepatocellular carcinoma.
J Vasc Interv Radiol.
2005;
16
(5)
743-746
- 4
Llovet J M, Vilana R, Brú C Barcelona Clínic Liver Cancer (BCLC) Group et al.
Increased risk of tumor seeding after percutaneous radiofrequency ablation for single
hepatocellular carcinoma.
Hepatology.
2001;
33
(5)
1124-1129
- 5
Jaskolka J D, Asch M R, Kachura J R et al..
Needle tract seeding after radiofrequency ablation of hepatic tumors.
J Vasc Interv Radiol.
2005;
16
(4)
485-491
- 6
Tarantino L, Francica G, Esposito F et al..
Seeding from hepatocellular carcinoma after percutaneous ablation: color Doppler ultrasound
findings.
Abdom Imaging.
2006;
31
(1)
69-77
- 7
de Baère T, Risse O, Kuoch V et al..
Adverse events during radiofrequency treatment of 582 hepatic tumors.
AJR Am J Roentgenol.
2003;
181
(3)
695-700
- 8
Livraghi T, Solbiati L, Meloni M F, Gazelle G S, Halpern E F, Goldberg S N.
Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications
encountered in a multicenter study.
Radiology.
2003;
226
(2)
441-451
- 9
Buscarini E, Buscarini L.
Radiofrequency thermal ablation with expandable needle of focal liver malignancies:
complication report.
Eur Radiol.
2004;
14
(1)
31-37
- 10
de Sio I, Castellano L, De Girolamo V et al..
Tumor dissemination after radiofrequency ablation of hepatocellular carcinoma.
Hepatology.
2001;
34
(3)
609-610, author reply 610–611
- 11
Bolondi L, Gaiani S, Celli N, Piscaglia F.
Tumor dissemination after radiofrequency ablation of hepatocellular carcinoma.
Hepatology.
2001;
34
(3)
608
author reply 610-611
- 12
Akahane M, Koga H, Kato N et al..
Complications of percutaneous radiofrequency ablation for hepato-cellular carcinoma:
imaging spectrum and management.
Radiographics.
2005;
25
(Suppl 1)
S57-S68
- 13
Yamanaka T, Shiraki K, Ito T et al..
Transcatheter arterial embolization and extrabeam radiation therapy for subcutaneous
seeding of hepatocellular carcinoma by percutaneous ethanol injection.
Hepatogastroenterology.
2002;
49
(48)
1656-1658
- 14
Shirato K, Morimoto M, Tomita N et al..
Hepatocellular carcinoma: a case of extrahepatic seeding after percutaneous radiofrequency
ablation using an expandable needle electrode.
Hepatogastroenterology.
2002;
49
(46)
897-899
- 15
Ishii H, Okada S, Okusaka T et al..
Needle tract implantation of hepatocellular carcinoma after percutaneous ethanol injection.
Cancer.
1998;
82
(9)
1638-1642
Ron C GabaM.D.
Section of Interventional Radiology, Department of Radiology, University of Illinois
Medical Center at Chicago
1740 West Taylor Street, MC 931, Chicago, IL 60612
eMail: rgaba@uic.edu
