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Case Report Open Access

Sequential microwave ablation combined with radioactive iodine‑125 seed implantation successfully cured multiple metastases of gallbladder cancer: A case report

  • Authors:
    • Wenjun Li
    • Yanwei Chen
    • Shuangshuang Zhao
    • Maohui An
    • Huajiao Zhao
    • Yun Cai
    • Jiayan Bao
    • Jiwen Qian
    • Baoding Chen
  • View Affiliations / Copyright

    Affiliations: Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212000, P.R. China
    Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 562
    |
    Published online on: October 1, 2025
       https://doi.org/10.3892/ol.2025.15307
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Abstract

Advanced tumors are associated with treatment dilemmas. High‑risk diffuse metastasis results in increased difficulty in treatment. Furthermore, the deterioration of the patient's physical condition gives rise to an inability to tolerate high‑intensity systemic treatment. As a palliative treatment for patients with advanced cancer, interventional therapy is characterized by precise targeting and fewer adverse reactions. Nevertheless, its role is frequently overlooked. Therefore, a female patient who only received local palliative treatment with microwave ablation and radioactive iodine‑125 seed implantation for multiple metastatic masses of gallbladder cancer is reported. This intervention achieved complete systemic remission, representing a rare instance of durable systemic remission without chemotherapy throughout the disease course, including the metastatic phase. The present study evaluated its immunological basis as an in situ vaccine strategy to benefit chemotherapy‑ineligible patients.
View Figures

Figure 1

Diagnostic and pathological
progression of gallbladder cancer. (A) Laparoscopic cholecystectomy
specimen showing poorly differentiated adenocarcinoma (H&E).
(B) IHC of primary tumor with positive CK18 confirming epithelial
origin. Magnification, ×400×. (C) Preoperative MRI showing
irregular gallbladder wall thickening (arrow) with adjacent hepatic
infiltration, suggesting residual malignancy. (D) Radical resection
specimen of residual poorly differentiated adenocarcinoma in
gallbladder bed (H&E, 200× magnification). (E) Clinical
presentation showing left neck mass (8×8 cm) with surface
ulceration prior to treatment. (F) Core-needle biopsy of neck mass
demonstrated malignant epithelial cells (H&E), consistent with
metastatic carcinoma. IHC of neck metastasis showing (G) Ki-67 (+,
75%) indicative of a high proliferative index, (H) CK7 (+),
indicating biliary differentiation and (I) AE1/AE3 (+) indicating
pan-cytokeratin confirmation of epithelial lineage. Magnification,
×100. IHC, immunohistochemistry; CK, cytokeratin; AE1/AE3,
cytokeratin AE1/AE3; H&E, hematoxylin and eosin.

Figure 2

Flow chart of the entire treatment
course and disease state. (A1-D1) Serial ultrasonographic images of
the largest left neck mass during postoperative follow-up,
demonstrating the evolution from pre-ablation to complete
resolution. (A2-D2) Serial ultrasonographic images of the left
axillary mass during postoperative follow-up, showing the
progression from pre-ablation to eventual disappearance. Arrows
indicate the location of the mass vs. the ablation foci. MWA,
microwave ablation; RSI, radioactive 125I seed
implantation.

Figure 3

Tumor indicator levels. Levels of (A)
CEA (normal, <5 ng/ml), (B) CA19-9, (normal, <37 U/ml) and
(C) CA72-4 (normal, <12 IU/ml). (D) Levels of total T cells
(CD3+)/lymphocytes (normal, 50–84%). CEA,
carcinoembryonic antigen; CA, carbohydrate antigen.
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Copy and paste a formatted citation
Spandidos Publications style
Li W, Chen Y, Zhao S, An M, Zhao H, Cai Y, Bao J, Qian J and Chen B: Sequential microwave ablation combined with radioactive iodine‑125 seed implantation successfully cured multiple metastases of gallbladder cancer: A case report. Oncol Lett 30: 562, 2025.
APA
Li, W., Chen, Y., Zhao, S., An, M., Zhao, H., Cai, Y. ... Chen, B. (2025). Sequential microwave ablation combined with radioactive iodine‑125 seed implantation successfully cured multiple metastases of gallbladder cancer: A case report. Oncology Letters, 30, 562. https://doi.org/10.3892/ol.2025.15307
MLA
Li, W., Chen, Y., Zhao, S., An, M., Zhao, H., Cai, Y., Bao, J., Qian, J., Chen, B."Sequential microwave ablation combined with radioactive iodine‑125 seed implantation successfully cured multiple metastases of gallbladder cancer: A case report". Oncology Letters 30.6 (2025): 562.
Chicago
Li, W., Chen, Y., Zhao, S., An, M., Zhao, H., Cai, Y., Bao, J., Qian, J., Chen, B."Sequential microwave ablation combined with radioactive iodine‑125 seed implantation successfully cured multiple metastases of gallbladder cancer: A case report". Oncology Letters 30, no. 6 (2025): 562. https://doi.org/10.3892/ol.2025.15307
Copy and paste a formatted citation
x
Spandidos Publications style
Li W, Chen Y, Zhao S, An M, Zhao H, Cai Y, Bao J, Qian J and Chen B: Sequential microwave ablation combined with radioactive iodine‑125 seed implantation successfully cured multiple metastases of gallbladder cancer: A case report. Oncol Lett 30: 562, 2025.
APA
Li, W., Chen, Y., Zhao, S., An, M., Zhao, H., Cai, Y. ... Chen, B. (2025). Sequential microwave ablation combined with radioactive iodine‑125 seed implantation successfully cured multiple metastases of gallbladder cancer: A case report. Oncology Letters, 30, 562. https://doi.org/10.3892/ol.2025.15307
MLA
Li, W., Chen, Y., Zhao, S., An, M., Zhao, H., Cai, Y., Bao, J., Qian, J., Chen, B."Sequential microwave ablation combined with radioactive iodine‑125 seed implantation successfully cured multiple metastases of gallbladder cancer: A case report". Oncology Letters 30.6 (2025): 562.
Chicago
Li, W., Chen, Y., Zhao, S., An, M., Zhao, H., Cai, Y., Bao, J., Qian, J., Chen, B."Sequential microwave ablation combined with radioactive iodine‑125 seed implantation successfully cured multiple metastases of gallbladder cancer: A case report". Oncology Letters 30, no. 6 (2025): 562. https://doi.org/10.3892/ol.2025.15307
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