title: [Renal-pleural fistula after radiofrequency ablation of renal tumor in VHL patient].
abstract: Radiofrequency is a minimally invasive therapy allowing tumor destruction by applying physical means to the core of the lesion. There is a particular indication for the hereditary already surgically treated renal carcinomas like Von Hippel-Lindau's disease. We present a case of renal-pleural fistula developed after a percutaneous radiofrequency ablation under computed tomography (CT) guidance of a renal tumor in a VHL female patient with a renal cell carcinoma of the upper pole of the left kidney. The kidney manifestations begin at 20-year-old with the appearance of cystic lesion at the lower pole of the left kidney. At 30-year-old, a computed tomography study revealed a solid lesion arising from a cyst. The patient underwent a partial nephrectomy by flank incision. Follow-up studies discovered three solid lesions of the upper pole of the left kidney. The patient undertook a radiofrequency ablation of these lesions. Follow-up control showed a contrast enhancement of one of the three lesions treated. Under this condition another course of RF was performed, complicated by a renal-pleural fistula. A conservative management of this iatrogenic fistula was attempted combining a water restriction and the insertion of a ureteral catheter. Three weeks were necessary until the fistula completely regress.
authors.affiliation: Service d'urologie, hôpital Européen-Georges-Pompidou (HEGP), Paris, France. pmouracade@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Mouracade
authors.forename: A
authors.initials: A
authors.lastname: Salin
authors.forename: Y
authors.initials: Y
authors.lastname: Rouach
authors.forename: M-O
authors.initials: MO
authors.lastname: Timsit
authors.forename: D
authors.initials: D
authors.lastname: Joly
authors.forename: J-M
authors.initials: JM
authors.lastname: Correas
authors.forename: A
authors.initials: A
authors.lastname: Mejean
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000209:etiology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D007680:Kidney Neoplasms / Q000209:etiology / Q000601:surgery*; D010995:Pleural Diseases / Q000209:etiology*; D016156:Respiratory Tract Fistula / Q000209:etiology*; D014548:Urinary Fistula / Q000209:etiology*; D006623:von Hippel-Lindau Disease / Q000150:complications