Editing Surgery of the Adrenals (section)

== Ablative Therapy for Adrenal Tumours ==

* Current indications for ablative therapy for adrenal tumors include patients with small tumors not keen on or suitable for surgery and palliation of painful metastases not amenable to resection.
* The 3 major thermal ablative techniques currently used are radiofrequency ablation (RFA), cryoablation, and microwave ablation.
** RFA utilizes frictional energy created by oscillating tissue ions to supply destructive heat to target tissue, with target tissue temperature ranging from 60-100° C resulting in protein and enzymatic degradation and cell death
** Cryoablation relies on rapid freezing and thawing to cause rupture of cell membranes resulting in cell death. The main advantage of this technique is the ability to follow iceball formation in real time with CT imaging.
** Microwave ablation creates an alternating electric field that causes oscillation of surrounding water dipoles resulting in tissue heating. Some have suggested that advantages of microwave ablation include the potential for larger ablation volumes, decreased procedural pain, and the potential to treat cystic lesions