Asian EUS Cup-05: Successful management of peripancreatic tumors by endoscopic ultrasound-guided radiofrequency ablation

BACKGROUND: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) could be used as an effective alternative treatment for peripancreatic tumor. Herein, we reported a case of adrenal adenoma which was treated by EUS-RFA. CASE REPORT: A 38-year-old woman presented with “moon face,” “buffalo hump,” and weight gain of 9 kg in 12 months. Initial contrast-enhanced abdominal computed tomography showed a 2.8 cm left adrenal mass, and the patient was diagnosed with Cushing’s syndrome due to left adrenal adenoma. She refused surgical treatment but agreed to undergo EUS-RFA. A 19-gauge endoscopic RFA electrode and radiofrequency generator were used for the procedure. The length of the exposed tip of the RFA electrode was 10 mm. After insertion of the RFA electrode into the mass, the radiofrequency generator was activated to deliver 50 W ablation power for 10 s. Depending on tumor size, the procedure was repeated to sufficiently cover the tumor. Therefore, EUS-RFA was performed successfully. There were no adverse events after EUS-RFA. CONCLUSIONS: EUS-RFA could be a technically feasible and safe modality for patients who refuse surgical treatment.