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

This case report describes a 49-year-old female with metastatic adrenocortical carcinoma (ACC) in the liver who experienced an abscopal effect following pulsed electric field (PEF) ablation. Despite initial treatments, including surgery and systemic therapy, the disease progressed, leading to the use of pembrolizumab and mitotane, followed by Y90 treatment. PEF treatment 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 highlights the potential of PEF ablation as both a local control strategy and an adjunct to systemic immunotherapy in treating liver tumors, suggesting the need for further studies to understand its mechanisms and benefits.