Ablative therapies in adrenal tumors: primary and metastatic

Successful percutaneous CT-guided microwave ablation of adrenal gland for ectopic Cushing syndrome

Adrenocorticotropic hormone production by pancreatic neuroendocrine tumor (PNET) is rare and results in hyperstimulation of the adrenal gland to produce ectopic Cushing syndrome. Our case showcases the safety and effectiveness of percutaneous CT-guided microwave ablation of the adrenal gland in a 49-year-old female with PNET and hepatic metastases who presented with ectopic Cushing syndrome despite surgical resection of the primary pancreatic tumor and left adrenal gland. Prior to ablation, the right adrenal gland measured 4.3×1.6×2.0cm and the patient had malignant hypertension with elevated morning serum cortisol level (1976nmol/L). After microwave ablation of the right adrenal gland, the hypertension resolved and the cortisol level decreased dramatically (74nmol/L). As expected after successful treatment, the patient developed adrenal insufficiency and was placed on glucocorticoid and mineralocorticoid supplementation.

Short-Term Outcomes and Safety of Computed Tomography-Guided Percutaneous Microwave Ablation of Solitary Adrenal Metastasis from Lung Cancer: A Multi-Center Retrospective Study

Objective

To retrospectively evaluate the short-term outcomes and safety of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of solitary adrenal metastasis from lung cancer.

Materials and Methods

From May 2010 to April 2014, 31 patients with unilateral adrenal metastasis from lung cancer who were treated with CT-guided percutaneous MWA were enrolled. This study was conducted with approval from local Institutional Review Board. Clinical outcomes and complications of MWA were assessed.

Results

Their tumors ranged from 1.5 to 5.4 cm in diameter. After a median follow-up period of 11.1 months, primary efficacy rate was 90.3% (28/31). Local tumor progression was detected in 7 (22.6%) of 31 cases. Their median overall survival time was 12 months. The 1-year overall survival rate was 44.3%. Median local tumor progression-free survival time was 9 months. Local tumor progression-free survival rate was 77.4%. Of 36 MWA sessions, two (5.6%) had major complications (hypertensive crisis).

Conclusion

CT-guided percutaneous MWA may be fairly safe and effective for treating solitary adrenal metastasis from lung cancer.

Highly stable microwave susceptible agents via encapsulation of Ti-mineral superfine powders in urea-formaldehyde resin microcapsules for tumor hyperthermia therapy

In this study, Ti-mineral superfine powders (Ti-MSP) encapsulated in urea-formaldehyde resin microcapsules (Ti-MSP@UF-MC) were successfully prepared via a one-step microemulsion method for the first time. Because of the strong confinement effects, the Ti-MSP@UF-MC possessed perfect microwave heating effects. The temperature was 9.3 °C higher than that of the saline solution, superior to UF-MC (no significant microwave heating effect, 0 °C) and Ti-MSP (5.1 °C). The Ti-MSP@UF-MC showed low toxicity and good biocompatibility via a series of studies, including a hemolysis study and the MTT assay in vitro and in vivo. When the concentration was below 1000 μg mL(-1), the hemolysis rate was lower than 5% (hemolysis study). When the concentration was below 400 μg mL(-1), the cell activity was higher than 80% (MTT assay). Moreover, the Ti-MSP@UF-MC exhibited an ideal CT imaging effect in vivo owing to the large molecular weight of Ti-MSP. The Ti-MSP@UF-MC showed a favorable microwave therapy effect in vivo. Using mice bearing H22 tumor cells as an animal model, the tumor suppression rate could reach 100%.