Nicoli Nicola, Casaril Andrea, Abu Hilal Moh'd, Mangiante Gerardo, Marchiori Luigi, Ciola Michele, Invernizzi Laura, Campagnaro Tommaso, Mansueto Giancarlo
Department of Surgery, Azienda Ospedaliera V. Cervello, Palermo, Italy.
Am J Surg. 2004 Aug;188(2):165-7. doi: 10.1016/j.amjsurg.2003.12.061.
Radiofrequency ablation (RFA) is a novel technique for the treatment of liver malignancies that is becoming increasingly more popular because of its feasibility, effectivity, repeatability, and safety. However, an increased number of complications after RFA has been reported in literature. The aim of this paper is to discuss the possible role of RFA in rapid intrahepatic spreading of hepatocellular carcinoma (HCC).
We treated a 66-year-old woman who had a 3.5-cm HCC with two courses of percutaneous RFA using a modified needle with seven hooks. The effectiveness of the treatment was assessed 1 month later by enhanced computed tomography.
Two courses of treatment were needed owing to the nodule position (close to the inferior vena cava). Computed tomography scan performed 1 month after the second RFA showed an intrahepatic arteriovenous fistula. Angiography performed after 1 month showed a rapid intrahepatic spreading of HCC.
Radiofrequency ablation can create an arteriovenous fistula that can facilitate migration of tumoral cells from the nodule to the hepatic portal system and rapid intrahepatic dissemination of HCC.
射频消融（RFA）是一种治疗肝脏恶性肿瘤的新技术，因其可行性、有效性、可重复性和安全性而越来越受欢迎。然而，文献报道RFA术后并发症数量有所增加。本文旨在探讨RFA在肝细胞癌（HCC）肝内快速播散中可能发挥的作用。
我们使用改良的七钩针为一名66岁患有3.5厘米HCC的女性进行了两疗程的经皮RFA治疗。1个月后通过增强计算机断层扫描评估治疗效果。
由于结节位置（靠近下腔静脉），需要进行两疗程治疗。第二次RFA术后1个月进行的计算机断层扫描显示肝内动静脉瘘。1个月后进行的血管造影显示HCC在肝内快速播散。
射频消融可形成动静脉瘘，促进肿瘤细胞从结节迁移至肝门系统，导致HCC在肝内快速播散。
