Argon helium knife and microwave ablation combined with particle implantation for giant fibroid tumor in the right chest

The patient is female, 32 years old, because of chest tightness and shortness of breath, she underwent chest X-ray and CT, PET-CT examination, and found a huge tumor in the right chest, and was refused surgical treatment by several hospitals. In September 2013, the CT scan was localized and showed a huge tumor in the right chest with leftward mediastinal compression. The tumor invaded the rib at the tip of the lung. The tumor basically occupied the whole right chest, and the chest wall and mediastinum were invaded. The mediastinum was significantly displaced. The tumor occupied the right thorax, and the right upper middle lung was compressed. After taking pathology, cryoablation treatment with argon helium knife was performed, and low-density ice ball formation was seen. Multi-needle multi-point cryotherapy. Multi-point cryoablation therapy. Postoperatively, a large amount of pleural effusion appeared. The right thoracic tumor was mostly non-enhancing and hypodense after ablation. However, more surviving tumors were still seen on the inner side of the tumor. The right thoracic tumor was mostly non-enhancing and hypodense on repeat CT as a post-ablation change. However, more surviving tumors were still seen on the inner side of the tumor. Most of the tumors in the right thorax showed non-enhancing hypodensity on repeat CT, which is a post-ablation change. However, more surviving tumors were still seen on the inner side of the tumor. There was a large amount of fluid in the right chest. The mediastinum was displaced by compression. Massive fluid accumulation in the right chest. The liver and mediastinum are displaced by compression. November 2013 CT scan localization phase, right thoracic tumor shrunk significantly, right pleural effusion disappeared. The right thoracic tumor shrank, but there were still more surviving tumors, mainly in the medial and upper part of the tumor. The right thoracic tumor shrank, but there were still more surviving tumors, mainly in the medial and upper part of the tumor. The tumor was treated by cold ablation with argon helium knife again. Postoperatively, a large amount of pleural effusion reappeared. Treatment such as tube drainage and diuretic supplementation with albumin was given. In March 2014, the CT scan localized the lesion, the pleural effusion disappeared, the patient’s chest tightness and shortness of breath disappeared, and he could go to work and work normally. The surviving tumor was still visible in the apical part of the lung. The center of the tumor is a non-enhancing hypodense area, suggesting tumor necrosis, but the peripheral foci of mild enhancement are still visible, suggesting residual tumor. The central part of the tumor is a non-enhancing hypodense area, suggesting tumor necrosis, but there are still foci of mild enhancement in the periphery, suggesting residual tumor, and the right lung has largely reopened. The right lung has been largely reopened. In April 2014, microwave ablation was performed for the residual tumor. The main treatment was for the apical lung tumor. Two microwave ablation needles were used for simultaneous treatment. The lesion was seen to be hypodense during the ablation process. January 2015 CT scan localization image The tumor had shrunk significantly, but the right upper thoracic deformity was localized due to tumor invasion of the rib cage. Enhancement scan showed that there was still a surviving tumor in the right pulmonary apex with localized rib invasion. The tumor was also seen in the medial aspect of the upper mediastinum. The right lung has basically reopened. The mediastinum was centered and not displaced. In February 2015, iodine 125 radioactive particle implantation was performed to treat the residual tumor. February 2015 Iodine 125 radioactive particle implantation was performed to treat the residual tumor. February 2015 Iodine 125 radioactive particle implantation was performed to treat the residual tumor. February 2015 Iodine 125 radioactive particle implantation for residual tumor. Now, 2 months after the last operation, the patient has no discomfort and lives a normal working life. The patient was in good health in the past, so when the tumor started to grow, she had slight symptoms but could still work, until she had obvious chest tightness and shortness of breath, the lesion had basically occupied the right side of the chest cavity. No one was accepted. Later, the patient came to our department for treatment because he knew our department was experienced in tumor ablation through many inquiries. Although a large amount of pleural effusion appeared after the operation, the patient’s basic physical quality was good, so it was easy to recover. The third time, because the lesion was concentrated in the upper part of the right lung, cold ablation could easily damage the local nerves and lead to the decrease of muscle strength of the right upper limb, so microwave ablation treatment was adopted. After the third treatment, the tumor had basically disappeared, but there was invasion of the right rib cage, so the fourth surgery used radioactive particle implantation to treat local bone metastases and residual tumor of the lung tip, with the purpose of avoiding nerve damage as much as possible. Fortunately, the muscle strength of the patient’s right upper limb was normal after surgery. At present, he has fully resumed his normal working life. Someone once said that “tumors are made for intervention and ablation”. I think this statement is a bit overstated, but there is no doubt that intervention and ablation can play a role in the treatment of many tumors. Unfortunately, the role of intervention and ablation in tumor treatment is still far from being applied. As a senior professional technician of interventional and ablation, I inevitably feel a little regret and loss. Hopefully, more medical personnel will master the precise technology of tumor ablation treatment tomorrow, and more patients will be able to benefit from tumor intervention and ablation technology.