Thermal ablation for local control of lung metastases and its effect on pulmonary function

Image-guided thermal ablation in the lung has consistently demonstrated preservation of lung function without permanent decline following treatment compared to other local treatment options, specifically surgical intervention or stereotactic radiation therapy. Here, we report a case of a 68-year-old female with mesonephric adenocarcinoma of the uterus metastatic to the lung, treated with primarily thermal ablation to manage her lung tumor burden. The patient underwent a hysterectomy and wedge resection of the left lower lobe in addition to first-line chemotherapy. To reduce the total lung tumor burden, in the absence of other more effective therapies and to strategically eradicate ultra-central lung tumors, the patient underwent multiple ablative therapies. In total, she underwent 45 ablation sessions, of which 42 were cryoablation with the rest conducted with microwave ablation, two stereotactic body radiation therapies, and one brachytherapy for 75 lung metastases. Pulmonary function tests were conducted before the start of serial ablation treatments and measured again after 32 ablation sessions which revealed minimal change in pulmonary function parameters while maintaining adequate functional status. We highlight the potential benefit of ablative therapies regarding pulmonary function compared to other local treatment options for metastatic lung cancer.