Acute pericarditis following treatment of a metastatic liver tumor with radiofrequency ablation: a case report

BACKGROUND: Radiofrequency ablation is a common and minimally invasive procedure used to treat liver tumors. However, the potential threat of heat injury to adjacent structures if the hepatic lesion is near the diaphragm is often overlooked and misunderstood. Rare cardiovascular complications have been reported. How best to identify the patients at risk to allow for prompt treatment is an important issue. CASE PRESENTATION: A 56-year-old man with underlying oral cancer received radiofrequency ablation for a metastatic liver tumor at segment II. Pleuritic chest pain developed on the day after radiofrequency catheter ablation. Diffuse ST elevation and echocardiography showed the new onset of small to moderate pericardial effusion without tamponade sign. Inflammatory markers were also elevated. Acute pericarditis due to heat penetration and stimulation was favored. His symptoms and signs resolved after treatment with anti-inflammatory medication. CONCLUSION: Potential cardiovascular complications are possible after radiofrequency catheter ablation for liver tumors located at segment II. Artificial ascites with normal saline before radiofrequency ablation may separate the liver and diaphragm to prevent cardiac complications. During the procedure, electrocardiographic monitoring and close observation of the patient’s symptom are required. Echocardiography can be used to confirm cardiac complications.