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Figure 9d. Microwave ablation of primary lung cancer in an 86-year-old man who presented with a suspicious right lower lobe mass in the azygoesophageal recess. (a) Preprocedure positron emission tomographic scans show localized fluorodeoxyglucose activity (arrows) with no nodal disease, findings consistent with stage 1 lung cancer. Results of onsite cytopathologic analysis of the biopsy specimen confirmed the diagnosis of non–small cell lung cancer. The mass was 4.3 cm in greatest dimension. (b) CT scan shows a 14.5-gauge microwave antenna that was advanced with fluoroscopic guidance into the mass along its superior portion. Two 10-minute, 45-W microwave ablations were performed. (c) On a postprocedure contrast-enhanced CT scan obtained through the lower thorax at the level of the mass, no marked enhancement within the lesion is seen. Note successful coagulation of the tumor up against the right inferior pulmonary vein (arrow). The patient was discharged to home in stable condition. (d) CT scan obtained at 9-month follow-up shows interval shrinkage and no enhancement of the mass (arrow).
