Percutaneous Laser Thermal Ablation in a Patient with 22 Liver Metastases from Pancreatic Neuroendocrine Tumours : A Case Report

The relatively indolent nature of well-differentiated neuroendocrine tumours (NET) and their proclivity to be hormonally active warrants aggressive multimodal treatment, even for advanced stage disease. Good results have been reported in well-selected patients with a median of 23 liver metastases (LM) from NET treated with surgical resection combined with intraoperative radiofrequency ablation. We report the case of a patient who underwent percutaneous laser thermal ablation (LTA) of 22 small LM from NET, treated over three consecutive sessions. After 2 years, five new LM were detected and treated with LTA. At present, 82 months after the first LTA session, the patient is still alive and disease-free. Due to enabling the use of one to four optical fibres at once to tailor the thermal lesion size to the nodule size, LTA could represent the ablation technique of choice in the presence of multiple, small, and variably sized LM.