Retroperitoneoscopic-guided radiofrequency ablation of renal tumors.
OBJECTIVE
Minimally invasive approaches to the management of renal tumors are being studied intensively in urology. Herein, we describe the use of multiple organ-sparing techniques for the management of tumors in a patient with von Hippel Lindau disease (VHL).


METHODS
A 42 year-old woman with VHL underwent a right partial adrenalectomy and a left renal radiofrequency ablation (RFA) of two renal tumors.


RESULTS
A 2.2 cm solitary right adrenal pheochromocytoma was resected using a transperitoneal approach. A retroperitoneal approach to the left kidney was performed and RFA of the two renal tumors completed using sonographic guidance. On the 5-month follow-up CT scan, there was no evidence of residual adrenal tumors and both renal lesions lacked contrast enhancement. No complications occurred during the post-operative recovery.


CONCLUSIONS
Multiple organ-ablative laparoscopic procedures may be performed in a single sitting. Laparoscopic partial adrenalectomy is an effective technique in patients with bilateral tumors or a familial syndrome predisposing to multiple adrenal tumors. Further study of renal RFA is required to assess the long-term durability of the procedure.
Pautler
S E
SE
Urologic Oncology Branch, National Cancer Institute and the Diagnostic Radiology Department, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA.
Pavlovich
C P
CP
Mikityansky
I
I
Drachenberg
D E
DE
Choyke
P L
PL
Linehan
W M
WM
Wood
B J
BJ
Walther
M M
MM
D000310:Adrenal Gland Neoplasms / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures; D010673:Pheochromocytoma / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D006623:von Hippel-Lindau Disease / Q000150:complications