Percutaneous radiofrequency ablation combined with microwave coagulation therapy under contrast-enhanced ultrasound guidance for treatment of melanoma metastasis to lymph nodes: a case report / 第二军医大学学报

ABSTRACT

Objective:To introduce our experience on treatment of melanoma metastasis to lymph nodes by percutaneous radiofrequency ablation combined with microwave coagulation therapy under contrast-enhanced ultrasound guidance and to assess the subsequent clinical efficacy. Methods: The 64 years old male patient with right sole melanoma had an enlarged right inguinal lymph node and received surgical resection twice within 9 months. During the following 2-7 months, more than 20 enlarged lymph nodes appeared along the right iliac artery and right lower limb, complicated with lower limb swelling. Surgical resection was ruled out due to the involvement of the iliac artery and the great number of the enlargements. Chemotherapy and Chinese herb medication were proven to be less effective, then a combined thermotherapy by radio frequency ablation (CelonLab-ENT, Germany) and microwave coagulation (YWY-2T, China) was employed percutaneously under the guidance of contrast-enhanced ultrasound for the treatment. The patient was followed up for 6 months. Results: Intra-and post-operation contrast-enhanced ultrasound scanning and biopsy pathology showed avascularity, necrosis, and atrophy in all the treated lymph nodes, with no obvious complications. The general condition of the patient was good and there was no new lesion found in other sites, except a few ones still receiving ablation in the right lower limb. Conclusion: Percutaneous radiofrequency ablation combined with microwave coagulation therapy under the guidance of contrast-enhanced ultrasound shows a stable killing effect for melanoma metastasis to lymph nodes in this patient, without obvious complications, and should be considered for more clinical applications.