Radiofrequency ablation in a previously irradiated liver

A patient with renal cell carcinoma underwent external-beam radiation therapy (XRT) to treat a painful chest-wall metastasis. One month later, she underwent radiofrequency (RF) ablation of two metastatic deposits within the liver; one of the target lesions was in the recent irradiation zone and the other was outside of the radiation field. RF ablation within the irradiated liver produced a slightly larger ablation zone with prominent needle tract scarring, and required less energy input than treatment in the unirradiated liver. RF ablation and XRT may interact, possibly producing a synergistic effect. Further study of the potentially adjunctive relationship between these two modalities is warranted.