Case Report: Pulsed Electric Field Treatment of Metastatic Liver Disease Demonstrating a Possible Abscopal Response

This case report discusses a 49-year-old female with metastatic adrenocortical carcinoma (ACC) in the liver who experienced an abscopal effect after pulse electric field (PEF) ablation. Despite initial treatments, including surgery and systemic therapy, her disease progressed, leading to the use of pembrolizumab and mitotane, followed by Y90 treatment. PEF was administered 7 months after starting pembrolizumab and mitotane. Remarkably, 2 months post-PEF, PET/CT imaging showed complete resolution of three out of four untreated lesions, indicating a possible abscopal response. This case suggests that PEF ablation may serve as a local control strategy and an adjunct to systemic immunotherapy in treating liver tumors, warranting further studies to understand its mechanisms and benefits.