Tuesday, 26 March 2024
MWA of an Osteosarcoma Metastasis after a Lung Resection
MWA of an Osteosarcoma Metastasis after a Lung Resection
1:58
Patient initially diagnosed with an Osteosarcoma in her left proximal fibula. Patient underwent above knee amputation. During a control CT of the lungs, several lymph nodules and a sclerotic lesion is visible. It was decided during a MDT meeting that the best treatment for this lung lesion was stereotactic lung ablation.
Planning scan in axial view with lung vessel segmentation in blue
![Screenshot 2024-03-08 164120](https://www.cascination.com/hs-fs/hubfs/Screenshot%202024-03-08%20164120.png?width=1200&height=745&name=Screenshot%202024-03-08%20164120.png)
Planning scan in the 3D reconstructed view of the segmented lung vasculature
![Screenshot 2024-03-14 102527](https://www.cascination.com/hs-fs/hubfs/Screenshot%202024-03-14%20102527.png?width=1200&height=735&name=Screenshot%202024-03-14%20102527.png)
Needle verification scan showing 2.2mm lateral error
![Screenshot 2024-03-14 102355](https://www.cascination.com/hs-fs/hubfs/Screenshot%202024-03-14%20102355.png?width=1200&height=730&name=Screenshot%202024-03-14%20102355.png)
Post-ablation CT scan confirming coverage of the lesion and margin
Name: Dr. Simon Smith
Institution: East Suffolk and North Essex NHS, Ipswich, UK
Patient sex, age: Female, 18 years old
Initial condition:
- Patient initially diagnosed with osteosarcoma in left fibula in 2021
- Patient underwent above knee amputation of her left leg and started chemotherapy
- Several lung lesions were discovered in July 2022
- It was decided to do a follow up CT of the lung lesions with 3 months intervals, while patient was still under chemo treatment
- In April 2023 patient underwent a left lobectomy of her metastatic sarcoma.
- A follow-up CT revealed a new lung lesion and It was decided to treat with ablation
- A CT scan two weeks prior to ablation showed a massive increase in size of the lesion
Treatment:
- The procedure was performed under general anesthesia
- Ablation was done using Medtronic Emprint HP generator
- The patient was in prone position during the whole procedure, accessing the lung through the back
- A 15cm needle was placed with 2mm precision and ablated for 6 minutes
Result:
- The lesion was successfully treated with stereotactic microwave ablation with sufficient ablation margins
- 3 month follow up scan showed adequate results
Learn more about the stereotactic navigation system CAS-One IR.