US-guided percutaneous laser ablation of refractory metastatic retroperitoneal lesions

RATIONALE Retroperitoneal metastatic lymph node is rare but severe, which has important structures like the gastrointestinal tract and large blood vessels around and may challenge excision, inducing serious complications like hemorrhage, intestinal adhesion, and even death after injury. PATIENT CONCERNS We described the case of a 60-year-old man with a history of right liver resection in 2010, pulmonary wedge resection in 2012, and transarterial chemoembolization twice in 2014, in which the postoperative pathology suggested the mixed liver cancer, and poorly differentiated lung cancer from liver metastasis. DIAGNOSES Preoperative magnetic resonance (MR) imaging scan showed a refractory retroperitoneal metastatic lymph node. INTERVENTIONS Then this patient repeatedly received 4 ablations with US-guided laser ablation within a month. OUTCOMES After 4 ablations due to residual tumor, MR, and CT images of 5-month follow-up showed the partial response. No obvious side effects were discovered in this case during these procedures. LESSONS This suggested US-guided laser ablation appears to be a useful technique for retroperitoneal metastatic lymph node with poor general condition or those refusing surgical therapy.