Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2020; 8(9): 1713-1720
Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1713
Application of curved ablation in liver cancer with special morphology or location: Report of two cases
Nan Cao, Huai-Jie Cai, Xi-Xi Sun, De-Lin Liu, Bin Huang
Nan Cao, Huai-Jie Cai, Xi-Xi Sun, De-Lin Liu, The Fourth Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Bin Huang, Department of Ultrasound, Zhejiang Hospital, Hangzhou 310013, Zhejiang Province, China
Author contributions: Cao N and Cai HJ contributed equally to this work; Cao N and Cai HJ participated in the design of the report, analyzed the data, and wrote the paper; Sun XX collected the medical imaging materials; Liu DL and Huang B designed the report and performed the preliminary revision of the article.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Bin Huang, MA, Chief Physician, Department of Ultrasound, Zhejiang Hospital, No. 1229, Gudun Road, Hangzhou 310013, Zhejiang Province, China. hb2k@163.com
Received: December 30, 2019
Peer-review started: December 30, 2019
First decision: March 5, 2020
Revised: March 26, 2020
Accepted: April 15, 2020
Article in press: April 15, 2020
Published online: May 6, 2020
Processing time: 122 Days and 2.4 Hours
Abstract
BACKGROUND

Liver cancer is one of the most common malignant tumors with a high incidence and mortality. Hepatitis-liver cirrhosis-liver cancer is known as the trilogy of liver cancer. At present, due to significant development of imaging interventions, they occupy an irreplaceable position in the field of liver cancer treatment, especially ultrasound-guided ablation. Because patients with liver cancer often present with liver cirrhosis, which leads to morphological deformation of the liver, it is difficult to perform a linear ablation of liver cancer in the areas near the phrenic top and within large blood vessels, among others. The present study reports on two cases of liver cancer that have been subjected to curvilinear ablation. After 1 mo, magnetic resonance imaging showed complete ablation, demonstrating that ultrasound-guided curved ablation is feasible and effective in the treatment of liver cancer.

CASE SUMMARY

Two patients were treated at the Liver Disease Department of the Xixi Hospital Affiliated to Zhejiang University of Chinese Medicine in 2019. Because the first liver cancer patient’s tumor was located close to the diaphragm, it was difficult to complete a straight needle ablation procedure in one session. In order to achieve accurate and minimally invasive treatment of this tumor, a curved needle ablation procedure was designed. The second patient presented with a hepatic cyst in front of the tumor. In order not to damage the hepatic cyst, a looper needle ablation technique was used. The procedure was successfully completed in both cases.

CONCLUSION

Curved ablation is a new technique that can be used to treat tumors situated in a variety of locations, providing new ideas for interventional techniques. Its operation difficulty is higher and further animal experiments are necessary to improve the operation procedure.

Keywords: Curved ablation; Ultrasound-guided; Liver cancer; Linear ablation; Case report

Core tip: Ultrasound-guided ablation of liver cancer plays an important role in the treatment of liver cancer. It has the advantages of less trauma and faster recovery, but is difficult to perform with a straight needle in certain portions of the liver tumor. This study reports on two cases of ultrasound-guided curved pathway ablation in order to expand the adaptive range of ultrasound-guided treatment of liver cancer and introduces this technique, thus providing ideas for future clinical treatments.