Endocrinol Metab.  2020 Dec;35(4):750-755. 10.3803/EnM.2020.880.

Percutaneous Adrenal Radiofrequency Ablation: A Short Review for Endocrinologists

Affiliations
  • 1Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Image-guided radiofrequency ablation (RFA) has been accepted as a minimally invasive treatment for adrenal tumors in patients who are unable to undergo adrenalectomy. Accordingly, this treatment has become more readily available for treating functioning or non-functioning adrenal masses. Thus, endocrinologists need a better understanding of percutaneous RFA of adrenal tumors. The purpose of this review is to briefly describe the basic mechanism of RFA, indications and contraindications, patient preparation prior to RFA, type of complications, how to avoid complications, RFA procedures, and treatment outcomes.

Keyword

Adrenal gland neoplasms; Radiofrequency ablation; Multidetector computed tomography

Figure

  • Fig. 1 A 60-year-old man with aldosterone-producing adenoma. (A) Contrast-enhanced axial computed tomography (CT) image shows a 2.5 cm left adrenal adenoma (arrow) with good enhancement. Adrenalectomy was failed because of severe adhesion which had developed since left hemicolectomy was performed to treat descending colon cancer. (B) Unenhanced axial CT image obtained during ablation procedures shows a radiofrequency electrode (arrowheads), which is advanced via left intercostal space and placed in the center of the left adrenal adenoma (arrow). (C) Unenhanced axial CT image obtained immediately after ablation was finished shows a small amount of acute hematoma (arrowheads) around the left adrenal adenoma (arrow). Hypertensive crisis occurred three times, but was well controlled with intermittent intravenous injection of alpha blockers. But also, turning off the power of generator was added to the medication in the first cycle of ablation. (D) Contrast-enhanced CT image obtained 1 month after ablation was finished shows no enhancement within the left adrenal adenoma (arrow). Arrowheads indicate the margin of ablation zone. His aldosterone-to-renin ratio was 471.58 before ablation and 5.27 after ablation. However, his blood pressure was reduced, but still ranged slightly higher.


Cited by  1 articles

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Endocrinol Metab. 2021;36(3):553-563.    doi: 10.3803/EnM.2021.1008.


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