Combined computed tomography-guided radiofrequency ablation and brachytherapy in a child with multiple recurrences of Wilms' tumor.
BACKGROUND
Treatment of relapsed Wilms' tumor remains a challenge. We describe a case of an 11-year-old girl with multiply relapsed Wilms' tumor in whom combined percutaneous computed tomography (CT)-guided radiofrequency ablation and brachytherapy directed at a retroperitoneal tumor mass resulted in pain palliation and local tumor control.


METHODS
Over the course of few weeks, her requirement for narcotic pain medications dramatically decreased. A contrast-enhanced CT scan obtained at 8 months after the procedure showed no evidence for local tumor recurrence. However, she subsequently developed myelodysplasia with evolution into leukemia, presumably secondary to chemotherapy, and died 9.5 months after the procedure.


CONCLUSIONS
Combined CT-guided radiofrequency ablation and brachytherapy is a promising new minimally invasive palliative treatment of recurrent Wilms' tumor.
Gandhi
Sachin
S
Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI 02903, USA.
Meech
Sandra J
SJ
Puthawala
Mohamedyakub A
MA
Ferguson
William S
WS
Cardarelli
Gene A
GA
Dupuy
Damian E
DE
D001706:Biopsy; D001918:Brachytherapy; D002648:Child; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local; D014057:Tomography, X-Ray Computed; D009396:Wilms Tumor / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*