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. 2025 Jul 1;6(1):e70171.
doi: 10.1002/deo2.70171. eCollection 2026 Apr.

Treatment of Hepatocellular Carcinoma Using Endoscopic Ultrasound-guided Radiofrequency Ablation: A Case Series

Yogesh Harwani  1 , Shreya Butala  1 , Varun Shukla  1 , Anand Patel  1 , Surbhi Dogra Jani  1
Affiliations

Treatment of Hepatocellular Carcinoma Using Endoscopic Ultrasound-guided Radiofrequency Ablation: A Case Series

Yogesh Harwani et al. DEN Open. .

Abstract

Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is an emerging technique for treating pancreatic and neuroendocrine tumors in patients who are not candidates for surgery. However, there is limited evidence of EUS-RFA in hepatic cancers. The present case series describes five elderly patients with compensated cirrhotic hepatocellular carcinomas (HCCs) treated locally using EUS-RFA. Alpha-fetoprotein levels were reduced in patients after 1 month of the procedure. Computed tomography analysis also reported a reduction in HCCs in patients postoperatively. Repeat computed tomography triple-phase abdomen also showed complete radiological response to treatment in lesions <3 cm. None of the patients reported any procedural adverse event. EUS-RFA offers safe ablation of <3 cm HCC lesions.

Keywords: case series; endoscopic ultrasound; hepatocellular carcinomas; liver cirrhosis; radiofrequency ablation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Diagrammatic representation of the feasibility of liver segments for endoscopic ultrasound‐guided radiofrequency ablation (EUS‐RFA) based on needle positioning.
FIGURE 2
FIGURE 2
Intraoperative linear endoscopic ultrasound (EUS) taken during the radiofrequency ablation (RFA) procedure. (a) Hepatocellular carcinoma (HCC) in segment III of the liver; (b) EUSRA RFA probe within lesion; (c) Echogenic bubbles observed post‐RFA.
FIGURE 3
FIGURE 3
(a) Pre‐ablation hepatocellular carcinoma (HCC) lesion at segment II in case 5; (b) 1‐month post‐ablation HCC lesion at segment II in case 5; (c) Pre‐ablation HCC lesion at segment VI in case 5; (d) 1‐month post‐ablation HCC lesion at segment VI in case 5.
See this image and copyright information in PMC

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