MWA of an Osteosarcoma Metastasis after a Lung Resection

MWA of an Osteosarcoma Metastasis after a Lung Resection


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

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Planning scan in the 3D reconstructed view of the segmented lung vasculature 

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Needle verification scan showing 2.2mm lateral error
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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 


  • 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 


  • 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.

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