Patient presents with HCC (4.8 cm centrally located in the right Liver) 6 month after mesorectal excision of a colorectal adenocarcinoma (CRC). He underwent neoadjuvant radiochemotherapy and was assessed free of tumour for the CRC. He had no liver metastases in prior examinations. Multidisciplinary tumour board (MTB) decision opted for tissue sparing local treatment due to suspected subclinical multifocal HCC.
The initial tumour bulk was covered by simultaneous microwave ablation with three antennas placed under CAS-One guidance. The overlapping ablation zones succeeded to cover the complete tumour in a confirmation CT-scan 72h post ablation. But the 6 month follow-up showed recurrent disease at the dorsal circumference of the ablation zone. This was treated with two overlapping microwave ablations in no-touch technique, again guided by CAS-One navigation. Patient was assessed disease free for the subsequent 1.5 years. He now returns with multifocal right sided hypervascular liver lesions (showcased on spectral CE-CT), confirmed as multifocal HCC disease. He is now treated with a combination of TACE and CAS-One guided ablations in a palliative setting, his quality of life is so far uncompromised (ECOG status 0-1). Treatment performed by Prof. Dr. Martin Hoffmann from St. Claraspital, Basel (Switzerland).
CRC after neoadj. Radio-Chemo and TME on CT, MRI showcasing a 4,8 cm Focal Lesion in Segment VIII, CAS-One Treatment Planning
Two days post first Ablation in 2018, 3 months after first Ablation, Local Recurrence (arrow) art. phase in 2019
Name: Prof. Dr. Martin Hoffmann
Institution: St. Claraspital, Basel, Switzerland
Patient age and sex: 79 years, male
Initial condition:
From CAS-One Planning to A0 in two Ablation sessions:
Treatment:
Result: