Needle tract seeding following percutaneous irreversible electroporation for hepatocellular carcinoma

Irreversible electroporation (IRE) is a non-thermal ablative technique for unresectable liver malignancies deemed unsuitable for traditional thermal ablation due to proximity to biliary and/or vascular structures. Needle tract tumour seeding is a well-recognised complication following thermal ablati...

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Bibliographic Details
Published in:BMJ case reports 2022-10, Vol.15 (10), p.e251880
Main Authors: Onafowokan, Oluwatobi O, de Liguori Carino, Nicola
Format: Article
Language:English
Subjects:
Abdomen
Ablation
Ablation Techniques - methods
Ascites
Biopsy
Carcinoma, Hepatocellular - surgery
Case reports
Case Reports: Adverse drug reactions and complications
Electroporation - methods
Humans
Hypertension
Inhibitor drugs
Intervention
Liver cancer
Liver diseases
Liver Neoplasms - pathology
Male
Medical imaging
Metastasis
Patients
Sorafenib
Targeted cancer therapy
Thrombosis
Tumors
Ultrasonic imaging
Veins & arteries
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Summary:Irreversible electroporation (IRE) is a non-thermal ablative technique for unresectable liver malignancies deemed unsuitable for traditional thermal ablation due to proximity to biliary and/or vascular structures. Needle tract tumour seeding is a well-recognised complication following thermal ablation, while little is known about its risk with IRE use. We present a case of tumour seeding after IRE for unresectable hepatocellular carcinoma in a man in his 70s. The procedure was complicated by bleeding from a pseudoaneurysm, which required coil embolisation and blood transfusion. He initially progressed well, however, imaging at 12 months indicated a new tumour in the right intercostal space along the tract of one of the IRE needles; consistent with seeding. Although the patient subsequently underwent systemic therapy with sorafenib, his disease progressed, and unfortunately he passed away 20 months following IRE. This report adds to mounting evidence of needle tract tumour seeding as a complication following IRE.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2022-251880