Year 2022 / Volume 114 / Number 7
Letter
Open wound and cutaneous fistulization after microwave ablation of hepatocarcinoma

428-429

DOI: 10.17235/reed.2022.8663/2022

Pablo Ladrón Abia, Daniel Mateos Millán, Adrián Picazo Bermúdez, Victoria Aguilera Sancho-Tello,

Abstract
A 64-year-old male with a history of HBV Child A MELD 9 cirrhosis on treatment with oral entecavir 0.5 mg/day. Diagnosed with 2 cm hepatocarcinoma in segment 6 treated by radiofrequency in April 2016 with complete response until June 2021, when an increase in the size of the solid component of the treated lesion (28 x 20 mm in diameter) was detected with early enhancement after the administration of paramagnetic contrast, suggestive of local tumor recurrence. Microwave ablation is a percutaneous thermal treatment that creates an electromagnetic field around a monopolar electrode, inducing homogeneous heating and coagulative tissue necrosis. It allows treating several lesions simultaneously and in less time than radiofrequency ablation with low morbidity and mortality. The incidence of adverse events ranges between 2.6% and 7.5%. The most frequent complications are bleeding and hematoma. Ablation tract fistulization is an infrequent complication, with a higher risk of appearing in subcapsular or peripheral hepatic lesions, as was the case in our patient.
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References
1. Liang P, Wang Y, Yu X, et al. Malignant liver tumors: treatment with percutaneous microwave ablation--complications among cohort of 1136 patients. Radiology. 2009; 251:933-940.
2. Dong B, Liang P, Yu X, et al. Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma: results in 234 patients. AJR Am J Roentgenol. 2003; 180:1547-1555.
3. Ma S, Ding M, Li J, et al. Ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma: clinical outcomes and prognostic factors. J Cancer Res Clin Oncol. 2017; 143:131-142.
4. Rogger TM, Michielan A, Sferrazza S, et al. Gastrointestinal tract injuries after thermal ablative therapies for hepatocellular carcinoma: A case report and review of the literature. World J Gastroenterol. 2020; 26:5375-5386.
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Ladrón Abia P, Mateos Millán D, Picazo Bermúdez A, Aguilera Sancho-Tello V. Open wound and cutaneous fistulization after microwave ablation of hepatocarcinoma. 8663/2022


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Publication history

Received: 29/01/2022

Accepted: 31/01/2022

Online First: 14/02/2022

Published: 07/07/2022

Article Online First time: 16 days

Article editing time: 159 days


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