Abstract No. 22: Bipolar Radiofrequency Ablation (RFA) for Symptomatic >10 Cm Giant Hepatic Hemangiomas: Initial Clinical Experience

Although most hemangiomas are asymptomatic and can be managed safely with observation alone, larger lesions may produce a variety of symptoms often requiring treatment. Traditionally, surgical resection has been the primary treatment of choice. However, if suitable for resection at all, this is associated with considerable morbidity and even a low risk of mortality. The objective of this report is to describe our first clinical experience with a novel bipolar radiofrequency ablation (RFA) device for symptomatic giant hepatic hemangiomas. Four consecutive patients with a large volume symptomatic hepatic cavernous hemangioma of >10cm were treated with a plan-parallel double expandable-needle bipolar RFA system (InCircle, RF Medical Inc., Fremont, USA) during laparotomy with ultrasound guidance. Complications were carefully noted. Clinical and radiological effectiveness was evaluated comparing baseline to 3 and 6 month follow-up symptom assessments and upper abdominal MRI or CT scans. RFA was successfully performed in all four patients. No major complications were observed. Per-procedural shrinking was remarkable and long-term volume reduction ranged 78-92% after 6 months. Symptom relieve after 6 months was complete in 2 patients and considerable in 2 patients (VAS symptom scores decreased from 7.5 to 1.3 on average). Preliminary results suggest the presented bipolar RFA system to represent a safe, fast, feasible and effective technique for treatment of giant (>10cm) symptomatic hepatic cavernous hemangiomas.