Radiofrequency ablation of subcapsular hepatocellular carcinoma: single center experience.

PURPOSE: To present a single center results, regarding radiofrequency ablation (RFA) of subcapsular hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Forty patients with subcapsular HCC were treated with RFA under CT guidance for fifty-two discrete lesions in our institution. Twenty-eight patients underwent ablation of a solitary tumor and twelve patients underwent RFA of two tumors. Six patients had a subcapsular HCC with an exofitic location. All lesions had a diameter of <4 cm. We used two types of generators and electrodes: spiral electrode and expandable electrode. Needle track ablation was performed in all cases. Follow-up consisted of an abdomen computed tomography (CT) scan after contrast administration immediately after each session and then after one, three, six, and twelve months. RESULTS: In forty-eight lesions complete tumor ablation was depicted at the one month CT scan. In four lesions with residual viable tumor, a second session was performed. After the second ablation no residual tumor was observed in any patient. No major complications occurred in any of our patients. Fever with a temperature up to 39 °C was documented during the first days as part of the post-ablation syndrome in thirteen patients (32.2%). Seeding along the needle track was observed in none of our patients. Local tumor progression, was observed in ten lesions (19.25%) and in all cases a second RFA session was performed with optimal results. CONCLUSION: Subcapsular location should not be considered as a contraindication for liver RFA.

Tumor-like pulmonary sarcoidosis diagnosed by CT-guided transthoracic lung biopsy.

INTRODUCTION: Most patients referred for lung biopsy have a focal lesion that is likely to be a carcinoma and fine needle aspiration (FNA) is usually sufficient to confirm diagnosis. Percutaneous cutting needle biopsy (CNB) is an important and potential diagnostic technique when non carcinomatous disease is suspected or when the pulmonary disease is unclear, so tissue architecture is very important. CASE PRESENTATION: We present a case of a 24 year old male arrived at our hospital with dyspnea and unusual computed tomography (CT) findings of sarcoidosis. Chest X-ray and CT scan revealed multiple masses in both lungs suggesting lung metastasis. Bronchoscopy and bronchoalveolar lavage did not reveal any malignant cells. None of the laboratory examinations revealed any primary extrapulmonary tumor. The patient underwent CT-guided core needle biopsy. Histopathological examination confirmed the diagnosis of sarcoidosis. CONCLUSION: CT-guided core needle biopsy is a very helpful diagnostic tool in order to determine the benign or malignant nature of a thoracic lesion.