Introduction/Background Uterine carcinosarcoma is a rare uterine tumor with an extremely poor prognosis and a high recurrence rate. 36% of carcinosarcoma patients with disease clinically confined to the uterus have nodal metastasis at the time of diagnosis and the majority of these patients will die of metastatic disease within 2 years of the diagnosis. There are no clearly defined treatment guidelines and no large controlled clinical trials have been conducted on metastatic carcinosarcoma. So, we tried to radiofrequency ablation procedure for retroperitoneal metastatic region in two cases.
Methodology The rational of RFA is based on the induction of coagulation necrosis in tissues secondary to hyperthermia. After the electrode was advanced into the LN and positioned against its deepest margin with US-CT fusion image guidance, ablation was performed with an impedance-control algorithm. Radiofrequency energy was applied with a mean power of 100 W (range, 80–120 W) for 5–10 minutes per radiofrequency application.
Results Case1: A 55-year-old woman underwent total hysterectomy, bilateral salpingo-oophorectomy due to abnormal uterine bleeding. The final pathological report was carcinosarcoma. Six months after chemotherapy, she developed distant metastasis to obturator lymph node and paravesical area. RFA was underwent for 10 minuites. 4 months after procedure, CT showed a remarkable reduction in the retroperitoneal metastatic mass.
Case2: A 62-year-old female underwent optimal surgery for MMMT. The final pathological report was carcinosarcoma, stage IV. Almost 5 months after adjuvant chemotherapy, a new retroperitoneal metastatic lesion was detected by CT scan. The lesion was subsequently treated with radiofrequency ablation.
Conclusion We can found the reduced RF ablated mass without local tumor progression in follow-up CT. Image-guided radiofrequency ablation (RFA) could be an alternative curative option for patients of uterine carcinosarcoma with retroperitoneal metastasis.
Disclosure Nothing to disclose
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