Radiofrequency ablation for treatment of sporadic angiomyolipoma.
BACKGROUND
Symptomatic angiomyolipoma (AML) and asymptomatic AML larger than 4 cm in size are usually treated with nephron-sparing surgery or arterial embolization. We used another technique, that is, radiofrequency ablation (RFA), for treatment of a sporadic AML in a patient with a solitary kidney, in whom maximal sparing of normal renal tissue was required.


METHODS
Contrast-enhanced computed tomography (CT) showed an enhancing well-defined mainly lipomatous tumor, with a maximum diameter of 4.5 cm in the upper pole of the left kidney. Diagnosis of AML was confirmed with fine-needle aspiration biopsy. RFA was performed with a RF 3000 system, consisting of a generator that supplied up to 200W of power, connected to a 15-gauge LeVeen multipolar array electrode that was placed under CT-guidance centrally in the AML. Initial power was set at low power and increased with increments of 10W, according to the algorithm provided by the manufacturer, resulting in a final tumor end temperature above 65 degrees C. No complications occurred and the patient was discharged home the day after. During follow-up (12 months) function of the solitary kidney of the patient was preserved and patient did not have any AML-related symptoms develop. Contrast-enhanced CT scan showed complete (100%) tumor ablation with absence of enhancement in the tumor and decreased tumor size from 4.5 cm to 2.9 cm at 12 months.


CONCLUSIONS
CT-guided RFA is a minimally invasive ablation procedure that allowed successful treatment of a sporadic AML in a patient with a solitary kidney. No complications occurred and no AML recurrence was observed during the 12-month follow-up.
Prevoo
Warner
W
Department of Radiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
van den Bosch
Maurice A A J
MA
Horenblas
Simon
S
D000368:Aged; D018207:Angiomyolipoma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation; D006801:Humans; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging; D007680:Kidney Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D014057:Tomography, X-Ray Computed