A case of salvage operation for the local recurrence following RFA to lung metastasis from colon cancer

Background. Radiofrequency ablation (RFA) for thoracic malignancy is emerging as a minimal invasive treatment, but the pathological effects are not sufficiently understood. We report a resected case of lung metastasis from colon cancer because of local recurrence after RFA. Case. A 65-year-old man underwent sigmoidectomy for sigmoid cancer in March 1999. In November 2004, he underwent systemic chemotherapy for a lung metastasis in the apical segment of left lower lobe. In April 2005, the lung metastasis progressed in the same location. According to the patient's wishes, he underwent the RFA. In May 2006, he underwent RFA again for the local recurrence of the ablated lesion. In December 2006, he underwent a salvage operation, left lower lobectomy with partial resection of the adventitia of descending aorta and soft chest wall tissue, for the local recurrence following the second RFA. The pathological findings confirmed that a large bronchus and pulmonary artery were involved in the recurrence lesion, but firm adhesion between tumor and aorta or chest wall consisted of fibrous tissue without viable cancer cells. The postoperative course was uneventful and he is alive 9 months after operation without any signs of recurrence. Conclusion. Further studies on the possible risk factors and mechanisms related with local recurrence are needed to determine the clinical indication of RFA treatment in lung malignant lesions. We reported a resected case of local recurrence following RFA of a lung metastasis from colon cancer.