RESUMEN:
Presentamos el caso clínico de un hombre de 71 años, con antecedentes de adenocarcinoma de recto cT3N1M0, previamente tratado con quimioterapia/radioterapia neoadyuvante y resección anterior del recto. En el seguimiento imagiológico, se identificó un nuevo nódulo pulmonar en crecimiento en el lóbulo superior izquierdo. Tras dos biopsias de este nódulo con material insuficiente, el paciente rechaza el tercer intento. Este nódulo es intensamente hipermetabólico en la PET-TC, sugestivo de metástasis. La decisión en equipo multidisciplinario fue tratar con termoablación por microondas del nódulo pulmonar. La termoablación guiada por imagen es una técnica en el campo de la Radiología de Intervención, que ha surgido como una opción mínimamente invasiva para el tratamiento de tumores en múltiples órganos, con diversas indicaciones y excelentes resultados. Una buena comprensión de las características imagiológicas (in)esperadas tras la termoablación, también presentadas en este artículo, es crucial para una vigilancia eficaz de estos pacientes.

ABSTRACT:
We present a clinical case of a 71-year-old man with history of rectal adenocarcinoma cT3N1M0, previously treated with neoadjuvant chemotherapy/radiotherapy and anterior resection of the rectum. During imaging follow-up, a new growing pulmonary nodule was identified in the left upper lobe. After two biopsies of this nodule yielded insufficient material, the patient refused a third attempt. This nodule is intensely hypermetabolic on PET-CT, suggestive of metastasis. The decision by a multidisciplinary team was to treat the pulmonary nodule with microwave ablation. Image-guided thermal ablation is a technique in the field of Interventional Radiology that has emerged as a minimally invasive option for treating tumors in multiple organs, with various indications and excellent results. A good understanding of the (un)expected imaging characteristics after thermal ablation, also presented in this article, is crucial for effective patient surveillance and management.

ABSTRACT:
We present a clinical case of a 71-year-old man with history of rectal adenocarcinoma cT3N1M0, previously treated with neoadjuvant chemotherapy/radiotherapy and anterior resection of the rectum. During imaging follow-up, a new growing pulmonary nodule was identified in the left upper lobe. After two biopsies of this nodule yielded insufficient material, the patient refused a third attempt. This nodule is intensely hypermetabolic on PET-CT, suggestive of metastasis. The decision by a multidisciplinary team was to treat the pulmonary nodule with microwave ablation. Image-guided thermal ablation is a technique in the field of Interventional Radiology that has emerged as a minimally invasive option for treating tumors in multiple organs, with various indications and excellent results. A good understanding of the (un)expected imaging characteristics after thermal ablation, also presented in this article, is crucial for effective patient surveillance and management.