Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 7, 2009; 15(13): 1653-1655
Published online Apr 7, 2009. doi: 10.3748/wjg.15.1653
Needle track seeding: A real hazard after percutaneous radiofrequency ablation for colorectal liver metastasis
Shirley Yuk-Wah Liu, Kit-Fai Lee, Paul Bo-San Lai
Shirley Yuk-Wah Liu, Kit-Fai Lee, Paul Bo-San Lai, Division of Hepato-biliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
Author contributions: Liu SYW, Lee KF and Lai PBS contributed equally to this work; Liu SYW wrote the draft of the manuscript; Lee KF and Lai PBS edited and prepared the manuscript.
Correspondence to: Paul Bo-San Lai, Professor, Chairman & Chief of Service, Division of Hepato-biliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. paullai@cuhk.edu.hk
Telephone: +852-26321309
Fax: +852-26377974
Received: November 27, 2008
Revised: March 2, 2009
Accepted: March 9, 2009
Published online: April 7, 2009
Abstract

Neoplastic needle track seeding following percutaneous radiofrequency ablation (RFA) of secondary liver tumors is exceedingly rare. Reports on cutaneous tumor seeding after percutaneous RFA for colorectal liver metastasis are even rarer in the literature. Here we report a case of a 46-year-old female who developed an ulcerating skin lesion along the needle track of a previous percutaneous RFA site around 6 mo after the procedure. The previous RFA was performed by the LeVeen® needle for a secondary liver tumor from a primary rectal cancer. The diagnosis of secondary skin metastasis was confirmed by fine needle aspiration cytology. The lesion was successfully treated with wide local excision. We believe that tumor seeding after percutaneous RFA in our patient was possibly related to its unfavorable subcapsular location and the use of an expansion-type needle. Hence, prophylactic ablation of the needle track should be performed whenever possible. Otherwise, alternative routes of tumor ablation such as laparoscopic or open RFA should be considered.

Keywords: Radiofrequency catheter ablation; Needles; Neoplasm seeding; Liver neoplasms; Skin neoplasms; Neoplasm metastasis