Nephron-sparing percutaneous ablation of a 5 cm renal cell carcinoma by superselective embolization and percutaneous RF-ablation.
OBJECTIVE
To report on the nephron-sparing, percutaneous ablation of a large renal cell carcinoma by combined superselective embolization and percutaneous radiofrequency ablation.


METHODS
A 5 cm renal cell carcinoma of a 43-year-old drug abusing male with serologically proven HIV, hepatitis B and C infection, who refused surgery, was superselectively embolized using microspheres (size: 500 - 700 microm) and a platinum coil under local anesthesia. Percutaneous radiofrequency ablation using a 7 F LeVeen probe (size of expanded probe tip: 40 mm) and a 200 Watt generator was performed one day after transcatheter embolization under general anesthesia.


RESULTS
The combined treatment resulted in complete destruction of the tumor without relevant damage of the surrounding healthy renal tissue. The patient was discharged 24 hours after RF ablation. No complications like urinary leaks or fistulas were observed and follow up CT one day and 4 weeks after the radiofrequency intervention revealed no signs of residual tumor growth.


CONCLUSIONS
The combined transcatheter embolization and percutaneous radiofrequency ablation of renal cell carcinoma has proved technically feasible, effective, and safe in this patient. It may be offered as an alternative treatment to partial or radical nephrectomy under certain circumstances.
Tacke
J
J
Department of Diagnostic Radiology, Technical University of Aachen, Germany. tacke@rad.rwth-aachen.de
Mahnken
A
A
Bücker
A
A
Rohde
D
D
Günther
R W
RW
D000328:Adult; D000792:Angiography; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000628:therapy*; D017115:Catheter Ablation; D004621:Embolization, Therapeutic; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008863:Microspheres; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed