title: Percutaneous ultrasound-guided radiofrequency ablation of an allograft renal cell carcinoma: a case report.
abstract: BACKGROUND
  Renal cell carcinomas (RCCs) are rarely described in transplanted kidneys. Available therapeutic strategies range from allograft nephrectomy to nephron-sparing procedures such as partial nephrectomy or image-guided thermal ablation. Percutaneous radiofrequency ablation (RFA) is a minimally invasive technique which provides promising oncologic outcomes in small allograft RCCs while preserving allograft function. So far, only a few cases have been reported in the transplant setting. We describe a renal transplant RCC successfully approached by ultrasound-guided RFA.
  
  
  METHODS
  A 42-year-old renal transplant recipient developed a small subcapsular allograft RCC at 11 years after transplantation. The decline in glomerular filtration rare prompted us to preserve as much parenchyma as possible. Ultrasound-guided RFA was performed under light sedation and local analgesia in a single session with a Starbust Talon needle.
  
  
  RESULTS
  Postablation contrast-enhanced ultrasound displayed a 25×23 mm avascular area of complete necrosis. After 3 months gadolinium-enhanced magnetic resonance imaging confirmed the absence of viable tumor tissue and while the patient did not experience any graft function reduction (serum creatinine 2.6 mg/dL).
  
  
  CONCLUSIONS
  Image-guided RFA represents a promising therapeutic modality for small allograft RCCs in recipients with mild graft dysfunction and/or elevated surgical risk. It is associated with low morbidity and parenchymal preservation.
authors.affiliation: Division of Infectious Diseases and Hepatology, Parma University Hospital, Parma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Olivani
authors.forename: M
authors.initials: M
authors.lastname: Iaria
authors.forename: G
authors.initials: G
authors.lastname: Missale
authors.forename: E
authors.initials: E
authors.lastname: Capocasale
authors.forename: E
authors.initials: E
authors.lastname: Biasini
authors.forename: M P
authors.initials: MP
authors.lastname: Mazzoni
authors.forename: L
authors.initials: L
authors.lastname: Lombardelli
authors.forename: E
authors.initials: E
authors.lastname: Luzi
authors.forename: A
authors.initials: A
authors.lastname: Frattini
authors.forename: G
authors.initials: G
authors.lastname: Pelosi
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D017115:Catheter Ablation; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional