Purpose To assess the effectiveness and safety of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) for lymph node (LN) oligometastases from hepatocellular carcinoma (HCC). Materials and Methods This retrospective study was approved by the institutional ethics committee, and all patients provided written informed consent. From January 2004 to December 2013, 119 consecutive patients with HCC and LN oligometastases (115 men [mean age, 51.3 years; age range, 16-83 years] and four women [mean age, 38.2 years; age range, 23-47 years]) were included in this study. A matched cohort composed of 46 patients from each group was selected after adjustment with propensity score matching. The median follow-up time was 14.0 months in the RFA group and 13.8 months in the non-RFA group. The overall survival (OS), local control rate, and complications were evaluated. Survival curves were constructed with the Kaplan-Meier method and compared by using the log-rank test. Results Eighty-seven patients had LN metastases located in the regional site, and 32 patients had LN metastases in the distant site. No significant differences were observed in the baseline characteristics between groups after propensity score matching adjustment. The RFA group showed higher 6-month and 1-year OS rates compared with the non-RFA group (87.0% and 58.3% vs 62.4% and 17.9%, respectively; P = .001). The 3-month local control rate after RFA was 84.4%, including complete response in 71.1% of patients and partial response in 13.3%. The complications of RFA were short-term abdominal pain and self-limited local hematoma, which occurred in 10 patients (21.7%) and five patients (10.9%), respectively. Conclusion Percutaneous CT-guided RFA may be a safe and effective treatment for the LN oligometastases generated by HCC. RSNA, 2016.

Primary mucinous adenocarcinoma of renal pelvis is an extremely uncommon malignant tumor without typical clinical manifestations and imaging characteristics. A definite diagnosis often depends on postoperative pathological results. Operation is the preferred choice of treatment, but prognosis is unsatisfactory. We describe a 42-year-old male patient who was admitted for repeated and intermittent pain of left abdominal flank for more than 5 years and aggravation of the symptom for more than 1 month. In the course of disease, he was misdiagnosed twice as a renal cyst in other hospitals. However, mild percussive pain was discovered in the left kidney area during this hospitalization. Moreover, abdominal computed tomography (CT) scan of our hospital demonstrated that a huge mixed-density mass derived from left kidney, along with congenital variation of the inferior vena cava and filling defect area in the left renal vein and the adjacent inferior vena cava. After adequate preoperative preparation, he was treated with radical resection of the left kidney and artificial vascular replacement of the inferior vena cava segment containing the emboli. The mass was verified to be mucinous adenocarcinoma by postoperative pathological result. In the end, he was diagnosed as primary mucinous adenocarcinoma of the left renal pelvis with ectopic inferior vena cava and invasion of the left renal vein and the adjacent inferior vena cava. Two weeks after operation, he recovered and was discharged. There was no evidence of recurrence after more than 4 years of followup. Blood oncogenic biomarkers were valuable in diagnosis by reviewing literature. In conclusion, Primary mucinous adenocarcinoma of the kidney is easy to be misdiagnosed as renal cyst. Preoperative CT and blood oncogenic biomarkers are extremely important for preliminary diagnosis. Postoperative pathological result is the gold standard for final diagnosis. Although prognosis is generally unfavourable, radical resection of the tumor can benefit patients.

Background: Patient-controlled intravenous analgesia (PCIA) is an increasingly used method to control postoperative pain. We aimed to investigate the association between PCIA and recovery after flap reconstruction in patients with oral squamous cell carcinoma (OSCC).Methods: Patients with OSCC who underwent flap reconstruction between 2016 and 2020 were reviewed (n=850). Baseline characteristics were compared between PCIA and non-PCIA groups. Propensity score matching (PSM) (1:4) was introduced to eliminate these confounding factors (n=505). Univariate analysis was performed to compare matched PCIA and non-PCIA group. Univariate and multivariate analyses were performed before and after PSM to identify factors that influenced length of stay (LOS) in hospital. The differences in characteristics of matched and unmatched groups were also compared.Results: Before PSM, the differences in flap types, smoking status, and radiotherapy history between PCIA and non-PCIA groups were statistically significant (P<0.05). After these factors were matched by PSM, LOS was 1.5 days shorter in the matched PCIA group than in the non-PCIA group (median, 10.5 versus 12.0, P=0.006). There was no significant difference in flap or medical complications, reoperations, or postoperative neutrophil-to-lymphocyte ratio (NLR) between the matched PCIA and non-PCIA groups. Postoperative glucose was lower in the matched PCIA group than in the non-PCIA group (median, 6.70 versus 7.30 mmol/L, P=0.021). Prolonged LOS was associated with postoperative PCIA, flap types, preoperative NLR, intraoperative red blood cell transfusion, fluid infusion rate over 24 h, and postoperative intensive care unit admission (P<0.05).Conclusions: Patients with OSCC using PCIA after flap reconstruction surgeries have a reduced LOS in hospital compared with those who used conventional postoperative analgesic strategies. Moreover, postoperative glucose increase was lower in the PCIA group than in the non-PCIA group.