New methodClinical endoscopyEUS-guided alcohol ablation of left adrenal metastasis from non-small-cell lung carcinoma
Section snippets
Patient and method
A 52-year-old man had had abdominal pain for 45 days, fatigue, and weight loss. Chest x-ray examination revealed a consolidated area in the left upper lobe (LUL) of the lung. CT scan revealed a mass in the LUL (Fig. 1) and mediastinal lymphadenopathy. CT-guided needle biopsy of the lung mass confirmed the diagnosis of large cell carcinoma (Fig. 2). Abdominal CT scan revealed a mass in the LA area that was considered highly suspicious for LAM (Fig. 3). An EUS revealed a 5-cm heterogenous lesion
Discussion
The adrenal gland is not an uncommon site of metastasis from lung, breast, and liver cancers. We here present a new technique of ablating LAM. Although the value of such a technique may be considered only for palliation of pain, potentially this technique could have therapeutic/survival benefits in combination with other treatments in lung cancer. This concept as described below is supported by published data and reports of surgical and percutaneous techniques for resecting or ablating adrenal
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Cited by (38)
EUS-guided intratumoral therapies: more time on the treadmill
2022, Gastrointestinal EndoscopyEndoscopic Ultrasound-Guided Ablation of Liver Tumors
2019, Gastrointestinal Endoscopy Clinics of North AmericaCitation Excerpt :The patient was followed for 2 years without recurrence of the tumor. Nongastrointestinal target lesions have included recurrent pelvic lymph node metastases as well as a metastatic adrenal lesion secondary to rectal adenocarcinoma.10–14 In addition to direct injection of sclerosing agents into tumors, EUS-FNI is also being explored as a novel method of administering chemotherapeutic or other antitumor agents.
Endoscopic ultrasound guided tumor directed therapy and cyst ablation
2017, Techniques in Gastrointestinal EndoscopyCitation Excerpt :However, the amount of alcohol, the number of sessions, and the needle type need to be standardized [1]. Success of EUS-guided ethanol injection has been reported in several organ tumors other than pancreas including stomach, liver, and adrenal glands [21-23,32-35]. Complete resolution of a 4 cm gastrointestinal stromal tumor in the stomach after EUS-guided alcohol injection has been reported [22].
EUS-Guided Ablation Therapy and Celiac Plexus Interventions
2014, Endosonography, Third editionTherapeutic applications of endoscopic ultrasound
2014, Ultrasound ClinicsEndoscopic Ultrasound-Guided Antitumor Agents
2012, Gastrointestinal Endoscopy Clinics of North AmericaCitation Excerpt :No complication developed in 4 patients treated with EUS-FNI, but 1 patient had minor bleeding and the other developed a 1.7 cm fluid collection in the ablative bed and an 8 cm pseudocyst, which did not require intervention, with IOUS-guided FNI. The similar technique of EUS-guided alcohol injection was also reported in a patient with left adrenal metastasis of non–small cell lung cancer for palliation of cancer-related pain.37 EUS-guided alcohol injection seems to have its role in patients with insulinoma who are poor candidates for surgical resection.