A Case of Solitary Metastasis from a Hepatocellular Carcinoma to the Sacral Bone Successfully Treated with Percutaneous Cryoablation

Abstract

A 70-year-old woman, who had previously undergone a hepatectomy for hepatocellular carcinoma (HCC), developed a solitary metastasis in the sacral bone with the symptom of limb pain. The tumor had been in remission for 2 years, after radiotherapy and chemotherapy with sorafenib; however, it recurred locally. Although we performed transcatheter arterial embolization (TAE) on the patient, her limb pain worsened gradually. We treated the patient further with percutaneous cryoablation. On the day after she underwent cryoablation, the patient developed a disturbance in gait with a dorsiflexion disorder of the left ankle. These symptoms were believed to be caused by a cryoinjury to the L5 nerve root, which was adjacent to the sacral tumor. After rehabilitation training for several days, the patient became ambulatory with an ankle brace. At her most recent follow-up visit, 18 months after the treatment, the patient did not exhibit the presence of either local tumor progression nor new metastases.