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Life-Threatening Complication During Percutaneous Ablation of Adrenal Gland Metastasis: Takotsubo Syndrome

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Abstract

A rare life-threatening complication during percutaneous cryoablation of an adrenal gland metastasis from a lung carcinoma is reported. The patient presented hypertensive crisis at the beginning of the thawing cycle, followed by electrocardiographic change which necessitated interruption of the procedure and his transfer to the intensive care unit with suspicion of heart infarct. There was a slight increase in cardiac enzyme levels, and ventricular angiography demonstrated transient hypokinesis-dyskinesis of the mid left ventricular segments without apical involvement, while the coronary arteries showed no significant stenosis on coronarography. These findings led to the diagnosis of Takotsubo cardiomyopathy left ventricular dysfunction syndrome. This is the first case of Takotsubo cardiomyopathy occurring as a complication during percutaneous ablation of an adrenal gland tumor.

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References

  1. Buy X, Tok CH, Szwarc D et al (2009) Thermal protection during percutaneous thermal ablation procedures: interest of carbon dioxide dissection and temperature monitoring. CardioVasc Interv Radiol (Epub ahead of print)

  2. Sato H, Tateishi H, Uchida T (1990) Tako-tsubo type cardiomyopathy due to multivessel spasm. In: Kodama K, Haze K, Hon M (eds) Clinical aspect of myocardial injury: from ischemia to heart failure. Kagakuhyouronsha, Tokyo, pp 56–64

    Google Scholar 

  3. Iga K, Gen H, Tomonaga T et al (1989) Reversible left ventricular wall-motion impairment caused by pheochromocytoma: a case report. Jpn Circ J 53:813–818

    PubMed  CAS  Google Scholar 

  4. Kurowski V, Kaiser A, von Hof K et al (2007) Apical and midventricular transient left ventricular dysfunction syndrome (tako-tsubo cardiomyopathy): frequency, mechanisms, and prognosis. Chest 132:809–816

    Article  PubMed  Google Scholar 

  5. Akashi Yo J, Goldstein D, Barbaro G et al (2008) Takotsubo cardiomyopathy: a new form of acute, reversible heart failure. Circulation 118(25):2754–2762

    Article  Google Scholar 

  6. Prasad A, Lerman A, Rihal CS (2008) Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction. Am Heart J 155:408–417

    Article  PubMed  Google Scholar 

  7. Koeth O, Mark B, Cornelius B et al (2007) Cardiogenic shock after adrenalectomy for pheochromocytoma. Internist (Berlin) 48(2):189–193

    Article  CAS  Google Scholar 

  8. Bland KL, Gass J, Klimberg VS (2007) Radiofrequency, cryoablation, and other modalities for breast cancer ablation. Surg Clin North Am 87(2):539–550

    Article  PubMed  Google Scholar 

  9. Permpongkosol S, Nielsen ME, Solomon SB (2006) Percutaneous renal cryoablation. Urology 68(Suppl 1):19–25

    Article  PubMed  Google Scholar 

  10. De La Taille A, Benson MC, Bagiella E et al (2000) Cryoablation for clinically localized prostate cancer using an argon-based system: complication rates and biochemical recurrence. BJU Int 85(3):281–286

    Article  Google Scholar 

  11. Lezoche E, Paganini AM, Feliciotti F et al (1998) Ultrasound-guided laparoscopic cryoablation of hepatic tumours: preliminary report. World J Surg 22(8):829–835; discussion 835–836

    Article  PubMed  CAS  Google Scholar 

  12. Bahn DK, Lee F, Solomon MH et al (1995) Prostate cancer: US-guided percutaneous cryoablation. Work in progress. Radiology 194(2):551–556

    PubMed  CAS  Google Scholar 

  13. Adams DA, Rand RW, Roth NH et al (1968) Cryoablation of the pituitary in the treatment of progressive diabetic retinopathy. Diabetes 17(10):634–640

    PubMed  CAS  Google Scholar 

  14. Cooper AJ, Fraser JD, MacIver A (1978) Host responses to cryoablation of normal kidney and liver tissue. Br J Exp Pathol 59(1):10–97

    Google Scholar 

  15. Patel BG, Parsons CL, Bidair M et al (1996) Cryoablation for carcinoma of the prostate. J Surg Oncol 63(4):256–264

    Article  PubMed  CAS  Google Scholar 

  16. Long JP, Faller GT (1999) Percutaneous cryoablation of the kidney in a porcine model. Cryobiology 38(1):89–93

    Article  PubMed  CAS  Google Scholar 

  17. Rhim H, Dodd GD III, Chintapalli KN et al (2004) Radiofrequency thermal ablation of abdominal tumours: lessons learned from complications. Radiographics 24(1):41–52

    Article  PubMed  Google Scholar 

  18. Callstrom MR, Atwell TD, Charboneau JW et al (2006) Painful metastases involving bone: percutaneous image-guided cryoablation—prospective trial interim analysis. Radiology 241(2):572–580

    Article  PubMed  Google Scholar 

  19. Clarke DM, Robilotto AT, Rhee E et al (2007) Cryoablation of renal cancer: variables involved in freezing-induced cell death. Technol Cancer Res Treat 6(2):69–79

    PubMed  Google Scholar 

  20. Beland MD, Dupuy DE, Mayo-Smith WW (2005) Percutaneous cryoablation of symptomatic extraabdominal metastatic disease: preliminary results. Am J Roentgenol 184(3):926–930

    Google Scholar 

  21. Bageacu S, Kaczmare K, Lacroix M et al (2007) Cryosurgery for resectable and unresectable hepatic metastases from colorectal cancer. Eur J Surg Oncol 33(5):590–596

    Article  PubMed  CAS  Google Scholar 

  22. Seifert JK, France MP, Zhao J (2002) Large volume hepatic freezing:association with significant release of the cytokines interleukin-6 and tumour necrosis factor in a rat model. World J Surg 26(11):1333–1341; Epub Sep 26

    Article  PubMed  Google Scholar 

  23. Rhim H, Yoon KH, Lee JM et al (2003) Major complications after radio-frequency thermal ablation of hepatic tumours: spectrum of imaging findings. Radiographics 23(1):123–136

    Article  PubMed  Google Scholar 

  24. Chini EN, Brown MJ, Farrell MA et al (2004) Hypertensive crisis in a patient undergoing percutaneous radiofrequency ablation of an adrenal mass under general anesthesia. Anesth Analg 99(6):1867–1869

    Article  PubMed  Google Scholar 

  25. Liang HL, Pan HB, Lee HY et al (1999) Small functional adrenal cortical adenoma:treatment with CT-guided percutaneous acetic acid injection-report of three cases. Radiology 213(2):612–615

    PubMed  CAS  Google Scholar 

  26. Maki DD, Haskai ZJ, Matthies A et al (2000) Case report—percutaneous ethanol ablation of the adrenal tumour. Am J Roentgenol 174(4):1031–1032

    CAS  Google Scholar 

  27. Rossi R, Savastano S, Tommaselli AP et al (1995) Percutaneous computed tomography-guided ethanol injection in aldosterone-producing adenocortical adenoma. Eur J Endocrinol 132(3):302–305

    Article  PubMed  CAS  Google Scholar 

  28. Onic G, Medary I, Berridge DM et al (2003) Life-threatening hypertensive crises in two patients undergoing hepatic radiofrequency ablation. Am J Roentgenol 181(2):495–497

    Google Scholar 

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Authors and Affiliations

  1. Department of Non Vascular Interventional Radiology, University Hospital of Strasbourg, 1 Place de l’Hôpital, 67091, Strasbourg, France

    Georgia Tsoumakidou, Xavier Buy & Afshin Gangi

  2. Department of Anaesthesiology, University Hospital of Strasbourg, 1 Place de l’Hôpital, 67091, Strasbourg, France

    Pierre Zickler

  3. Department of Cardiology, University Hospital of Strasbourg, 1 Place de l’Hôpital, 67091, Strasbourg, France

    Michel Zupan & Marie-Pierre Douchet

Authors
  1. Georgia Tsoumakidou
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  2. Xavier Buy
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  3. Pierre Zickler
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  4. Michel Zupan
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  5. Marie-Pierre Douchet
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  6. Afshin Gangi
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Correspondence to Afshin Gangi.

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Tsoumakidou, G., Buy, X., Zickler, P. et al. Life-Threatening Complication During Percutaneous Ablation of Adrenal Gland Metastasis: Takotsubo Syndrome. Cardiovasc Intervent Radiol 33, 646–649 (2010). https://doi.org/10.1007/s00270-009-9612-9

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  • DOI: https://doi.org/10.1007/s00270-009-9612-9

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