Tumor Cell Needle Tract Seeding and Intracardiac Migration Following Percutaneous Image Guided Fiducial Seeds Implantation: A Two Rare Complications

Background: Fiducial markers are useful for stereotactic body radiotherapy for treatment of malignant tumors. Here, we report two cases of rare complications following percutaneous fiducial markers placement. Methods: First case, a 51-year-old male with high grade metastatic neuroendocrine tumour of the liver who underwent ultrasound guided placement of four fiducial markers in the right hepatic lobe tumour. Second case, a 41-year-old lady with rectal adenocarcinoma and pulmonary metastasis who underwent CT guidance fiducial markers placement in four metastatic lung lesions. Results: First case developed tumor cell seeding along the needle tract of the fiducial marker placement procedure. This was detected on follow up cross sectional imaging. Second case developed intracardiac migration of one of the fiducial markers into the left ventricle during the procedure. The patient continues to be totally asymptomtic on follow up after one and half month after the procedure. The migrated fiducial marker has not changed its location in the left ventricle as well. Conclusions: Although rare, tumour cell tract seeding and intracardiac migration following percutaneous fiducial markers placement are potential complications and should be taken in consideration.

Publication History

Article published online:
26 April 2021