Ablative Treatment of Hepatic Recurrence of Lung Cancer Using Electrochemotherapy : A Case Report

Abstract

Introduction: Electrochemotherapy (ECT) is a locally enhanced chemotherapy that combines the administration of chemotherapeutic drugs with welldosed electric pulses for cell membrane Electroporation (EP). As opposed to thermal ablation, cell death with ECT is primarily induced using electrical energy: electrical pulses disrupt the cellular membrane integrity, resulting in cell death while sparing the extracellular matrix of sensitive structures such as the bile ducts, blood vessels, and bowel wall. This article reports the successful non-thermal ablation treatment of a hepatic recurrence of lung cancer as an individual treatment in order to achieve loco-regional tumor control. Case Presentation: 50-year-old Caucasian woman was referred for interventional treatment of the largest of the hepatic metastases of lung cancer (6.0 × 4.8 cm), located in the left hepatic lobe and close to the left suprahepatic vein. Due to the size and the immediate proximity to the left suprahepatic vein the patient could neither undergo ablation treatments (RFA or MWA) neither TACE because of tumor size and the high risk of thermal sinks (“heat-sink effect”) potentially resulting in reduction of complete treatment of the target lesion. Due to its ablation mechanism, electrochemotherapy with use of bleomicin was deemed to be the best therapy option for the patient as loco-regional disease control. Conclusions: Due to its more selective and non-thermal ablation effect , percutaneous ECT is a novel, potentially very effective treatment option in minimally invasive oncologic treatments, especially for hepatic metastases. We showed in this case report that a large hepatic metastatic lesion adjacent to the left suprahepatic vein can be widely ablated by ECT with ablation of a large infiltrating tissue volume.