A case of rapid intrahepatic dissemination of hepatocellular carcinoma after radiofrequency thermal ablation.
BACKGROUND
Radiofrequency ablation (RFA) is a novel technique for the treatment of liver malignancies that is becoming increasingly more popular because of its feasibility, effectivity, repeatability, and safety. However, an increased number of complications after RFA has been reported in literature. The aim of this paper is to discuss the possible role of RFA in rapid intrahepatic spreading of hepatocellular carcinoma (HCC).


METHODS
We treated a 66-year-old woman who had a 3.5-cm HCC with two courses of percutaneous RFA using a modified needle with seven hooks. The effectiveness of the treatment was assessed 1 month later by enhanced computed tomography.


RESULTS
Two courses of treatment were needed owing to the nodule position (close to the inferior vena cava). Computed tomography scan performed 1 month after the second RFA showed an intrahepatic arteriovenous fistula. Angiography performed after 1 month showed a rapid intrahepatic spreading of HCC.


CONCLUSIONS
Radiofrequency ablation can create an arteriovenous fistula that can facilitate migration of tumoral cells from the nodule to the hepatic portal system and rapid intrahepatic dissemination of HCC.
Nicoli
Nicola
N
Department of Surgery, Azienda Ospedaliera V. Cervello, Palermo, Italy.
Casaril
Andrea
A
Abu Hilal
Moh'd
M
Mangiante
Gerardo
G
Marchiori
Luigi
L
Ciola
Michele
M
Invernizzi
Laura
L
Campagnaro
Tommaso
T
Mansueto
Giancarlo
G
D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D016461:Chemoembolization, Therapeutic; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D009366:Neoplasm Seeding; D011169:Portal Vein