Purpose: To evaluate the morbidity and efficacy of percutaneous radiofrequency ablation
(RFA) performed before surgical resection for multiple residual lung metastases of
germ cell tumors with negative tumor markers. Materials and Methods: This Review Board-approved
retrospective study was carried out on five consecutive patients (mean age: 31 years,
range: 22–41) treated successively with percutaneous RFA and surgery for multiple
lung metastases of germ cell tumors. Mean number of lung metastases before treatment
was 9.4. Staged procedures were performed on an average of 7.2 months (range: 1–16)
after the primitive tumor resection. Results: The median clinical and imaging follow-up
was 26 months (range: 24–36). Percutaneous RFA was technically feasible in one session
under general anesthesia and CT guidance in all cases. On average, 2.8 tumors were
ablated per patient (range: 1–6), and three of five procedures were bilateral. Three
patients developed pneumothorax requiring drainage, but no severe complications were
reported. Mean time between RFA and surgical resection of residual tumors was 2.5
months (range: 1–5). No local recurrences were noted, but one patient died due to
metastatic evolution. Conclusion: Staged percutaneous RFA and surgical resection could
be efficient with low morbidity for the management of multiple lung metastases of
germ cell tumors.
Germ cell tumor - lung metastasis - radiofrequency ablation - surgery
