CT-Guided Percutaneous Microwave Ablation of Sclerosing Hepatic Carcinoma

Figure 1

Three cases of ablation failure experienced before 2012 when preoperative biopsy was not routinely performed. (a) A 64-year-old male with sclerosing hepatocellular carcinoma who underwent surgical resection after ablation failure. The initial ablation site was indicated, showing the poor ablation scope and efficacy. The subsequent immunohistostaining revealed a severe fibrous component (∼80% of the tumor tissue) causing unexpected hardness, a high level of heat resistance, and poor heat conduction. (b) A 37-year-old male patient with bile duct adenocarcinoma who underwent surgical resection. The immunohistostaining indicated mild fibrosis (∼40%). The failure cause was the displacement of the rubbery tumor during puncture and a high level of heat resistance. (c) A 72-year-old female patient with intrahepatic cholangiocarcinoma. Typical cystic changes were found in histological sections. The rigid tumor capsule composed of a fibrous component and necrotic tumor tissue completely prevented puncture.

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