Erik Soule1, Arya Bagherpour1, Jerry Matteo1. 1. Department of Interventional Radiology, UF Health Jacksonville, University of Florida, Jacksonville, Florida, USA.
Abstract
BACKGROUND: Neuroendocrine malignancy is indolent, yet relentless in its propensity to metastasize to the liver, where it may cause bizarre paraneoplastic syndromes. The pathophysiologic mechanism behind this predilection for hepatic metastasis is twofold: the portal venous system drains the most likely primary sites for neuroendocrine tumors, and the relatively immunosuppressed environment within the hepatic parenchyma is permissive for tumor growth. The standard of care for patients with metastatic neuroendocrine tumor is surgical resection of at least 90% of the tumor burden. METHODS: This report describes CT-guided percutaneous cryoablation of an inoperable mesenteric carcinoid tumor that had previously demonstrated hepatic metastases utilizing hydrodissection to safely and effectively prevent further metastasis while priming the immune system to eradicate this malignancy systemically. RESULTS: CT-guided percutaneous cryoablation is minimally invasive, has intrinsic analgesic properties, and may contribute to sensitization of the immune system against tumor antigens. CONCLUSION: Percutaneous cryoablation with hydrodissection can be used to target intraabdominal malignancy in poor surgical candidates. This procedure is safe, effective, and minimally invasive.
BACKGROUND:Neuroendocrine malignancy is indolent, yet relentless in its propensity to metastasize to the liver, where it may cause bizarre paraneoplastic syndromes. The pathophysiologic mechanism behind this predilection for hepatic metastasis is twofold: the portal venous system drains the most likely primary sites for neuroendocrine tumors, and the relatively immunosuppressed environment within the hepatic parenchyma is permissive for tumor growth. The standard of care for patients with metastatic neuroendocrine tumor is surgical resection of at least 90% of the tumor burden. METHODS: This report describes CT-guided percutaneous cryoablation of an inoperable mesenteric carcinoid tumor that had previously demonstrated hepatic metastases utilizing hydrodissection to safely and effectively prevent further metastasis while priming the immune system to eradicate this malignancy systemically. RESULTS: CT-guided percutaneous cryoablation is minimally invasive, has intrinsic analgesic properties, and may contribute to sensitization of the immune system against tumor antigens. CONCLUSION: Percutaneous cryoablation with hydrodissection can be used to target intraabdominal malignancy in poor surgical candidates. This procedure is safe, effective, and minimally invasive.
Authors: Eric M Vikingstad; Gustaaf G de Ridder; Richard R Glisson; Diana M Cardona; Devon DiPalma; William C Eward; Brian E Brigman; Rendon C Nelson; Charles Y Kim Journal: J Vasc Interv Radiol Date: 2015-06-09 Impact factor: 3.464
Authors: Matias Riihimäki; Akseli Hemminki; Kristina Sundquist; Jan Sundquist; Kari Hemminki Journal: Int J Cancer Date: 2016-09-09 Impact factor: 7.396
Authors: Paul B Shyn; Giovanni Mauri; Raquel Oliva Alencar; Servet Tatli; Shaan H Shah; Paul R Morrison; Paul J Catalano; Stuart G Silverman Journal: AJR Am J Roentgenol Date: 2014-02-20 Impact factor: 3.959
Authors: Giovanni Mauri; Luca Nicosia; Gianluca Maria Varano; Paul Shyn; Sergio Sartori; Paola Tombesi; Francesca Di Vece; Franco Orsi; Luigi Solbiati Journal: Ecancermedicalscience Date: 2017-04-18
Authors: Rongzhi Wang; Rui Zheng-Pywell; H Alexander Chen; James A Bibb; Herbert Chen; J Bart Rose Journal: Clin Med Insights Endocrinol Diabetes Date: 2019-10-24