Rare Treatment for a Rare Tumor: Cryoablation of a Granular Cell Tumor.

BACKGROUND: Granular cell tumors (GCTs) or Abrikossoff's tumors are rare neoplasms known to originate from Schwann cells in the peripheral nervous system. These lesions are usually benign; malignancy only occurs in 1-2% of cases. Surgical resection is the traditional treatment method for GCTs, but it poses several risks and disadvantages related to the surgical incompatibility of the patient, the extended recovery time, and the chance of relapse. Cryoablation is becoming an increasingly favored method of treatment for tumors, both benign and malignant, due to its minimal invasiveness, natural analgesic properties, and ability to stimulate antitumor immunity. Cryoablation may contribute to the prevention of secondary and metastatic tumor growth in cases of malignancy by preserving tumor-associated antigen molecules for recognition by cell-mediated immunity. METHODS: This article describes a novel method for GCT treatment using cryoablation. This technique exposes tumor tissue to extreme cold temperatures, effectively destroying tumor cells by irreversibly compromising their plasma membranes. To our knowledge, this is the first report in the literature of cryoablative techniques being used for GCT. RESULTS: Cryoablation of this mass was successful with no complications. CT images during the procedure demonstrated circumferential coverage of the entire lesion with no injury to the surrounding tissues. CONCLUSION: Cryoablation can be used as an alternative to surgical intervention to treat malignant GCTs. This procedure is minimally invasive, less painful, and potentially effective in promoting antitumor immunity.

Mind the gap: A novel endovascular technique to repair a transected vessel.

Level one trauma centers experience horrific injuries on a regular basis. Blunt or penetrating trauma causing vascular injuries are treated by surgeons and interventional radiologists. When a blood vessel is completely transected, the ends of the vessel retract and vasospasm occurs as a normal survival response. When this phenomenon occurs, it is sometimes impossible to reattach the two ends of the injured vessel by surgical means and a bypass graft is often required. However, from an endovascular perspective, covered stents can serve as a vascular bypass as well. The limiting factor with an endovascular approach is the ability to successfully gain wire access across the injured vessel. The technique described in this manuscript describes a "rendezvous" method of repairing a transected axillosubclavian artery from a high-speed motorcycle accident using a steerable microcatheter. Initially, multiple failed attempts to cross the injured vessel were encountered despite using a wide variety of conventional guidewires and catheters. A steerable microcatheter was then used to safely and effectively navigate more than 15 cm through soft tissue to the opposite end of the vessel. In this critically ill patient, this technique significantly reduced the procedural time when compared to our previous experiences repairing arterial transections using traditional catheters.