Percutaneous CT-guided cryoablation of desmoid tumors: single-center experience with volumetric midterm outcome

Abstract Purpose Desmoid tumors are rare mesenchymal neoplasms with a propensity for local recurrence and significant morbidity. Percutaneous cryoablation has emerged as a promising treatment option, yet data on volumetric outcomes remain limited. This small study evaluated the safety and preliminary efficacy of percutaneous CT-guided cryoablation of desmoid tumors with systematic volumetric assessment of tumor volume. Materials and methods A retrospective single-center analysis was performed on 13 consecutive patients (median age 39 years) who underwent percutaneous CT-guided cryoablation of desmoid tumors with a standardized double freeze–thaw protocol. Dissection techniques included hydrodissection (53.8%), CO₂ pneumodissection (15.4%), and air dissection (7.7%). Viable tumor volume was assessed on contrast-enhanced MRI measured by the ellipsoid formula. Response was evaluated by mRECIST criteria, and complications were graded per the CIRSE classification system. Results Technical success was achieved in all 13 procedures. One patient (7.7%) experienced a CIRSE grade 3b complication. Among the remaining 12 patients (median follow-up 14.5 months, range 4.0–53.0), median enhancing tumor volume decreased from 70.5 cm 3 (IQR 31.8–102.8; range 9.0–302.0) at baseline to 1.97 cm 3 (IQR 0.14–5.07; range 0.0–8.26) at last follow-up (median volume reduction − 98.3% (IQR − 99.8% to − 94.2%; p < 0.001, Wilcoxon signed-rank test; Cohen’s d = 1.00)). By mRECIST, 6 patients (50.0%) achieved complete response and 6 (50.0%) achieved partial response. Symptom improvement was reported in 12 of 13 patients (92.3%). Conclusion Percutaneous CT-guided cryoablation of desmoid tumors is an effective treatment, achieving near-complete elimination of viable tumor volume with very few severe complications, good symptomatic relief, marked reduction of T2 MRI signal after cryoablation, and no observed disease progression during midterm follow-up in a small cohort of patients.