Liver metastasis from pancreatic neuroendocrine tumors after pancreaticoduodenectomy successfully treated by radiofrequency ablation combined with transcatheter arterial embolization: A case report. (2020) - Hashimoto, Kazuhiko
Highlights: RFA and IVR treatment is expected to control local disease activity and improve survival rates for the liver metastasis from pNETs. RFA and IVR treatment should be very carefully performed after pancreaticoduodenectomy or biliary reconstruction. This report details our experience in using RFA combined with TAE to treat liver metastasis from a pNET after pancreaticoduodenectomy. Abstract: Background: Surgical resection is the first-choice treatment for operable liver metastases from pancreatic neuroendocrine tumors (pNETs). However, radiofrequency ablation, transcatheter arterial chemoembolization, and interventional radiology are expected to control local disease activity and improve survival rates in patients not eligible for surgery. Presentation of case: A 54-year-old woman underwent pancreaticoduodenectomy for treatment of an 80-mm-diameter pancreatic head tumor. Histologically, the pancreatic tumor was diagnosed as a nonfunctional pNET (G2). At 38 months postoperatively, abdominal computed tomography showed two 15-mm-diameter liver tumors in segment 3 and segment 5/6, respectively. The patient requested nonsurgical treatment. Therefore, radiofrequency ablation combined with transcatheter arterial embolization was performed for the liver metastases. No complications occurred after the therapy. She was alive without recurrence at the time of this writing (33 months after the liver metastasis therapy, 74 months after the operation). Discussion: Although interventional radiology and radiofrequency ablation should be very carefully performed after pancreaticoduodenectomy or biliary reconstruction, our patient showed a good response to treatment without serious complications. Conclusion: This report details our experience in treating liver metastasis from a pNET after pancreaticoduodenectomy. The metastasis was successfully treated by radiofrequency ablation combined with transcatheter arterial embolization.