Nephron-sparing percutaneous ablation of a 5 cm renal cell carcinoma by superselective embolization and percutaneous RF-ablation

Purpose: To report on the nephron-sparing, percutaneous ablation of a large renal cell carcinoma by combined superselective embolization and percutane ous radiofrequency ablation. Materials and Methods: A 5 cm renal cell carci noma of a 43-year-old drug abusing male with serologically proven HIV, hepa titis B and C infection, who refused surgery, was superselectively embolize d using microspheres (size: 500-700 mum) and a platinum coil under local an esthesia. Percutaneous radiofrequency ablation using a 7 F LeVeen probe (si ze of expanded probe tip: 40 mm) and a 200 Watt generator was performed one day after transcatheter embolization under general anesthesia. Results: Th e combined treatment resulted in complete destruction of the tumor without relevant damage of the surrounding healthy renal tissue. The patient was di scharged 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 radi ofrequency intervention revealed no signs of residual tumor growth. Conclus ion: The combined transcatheter embolization and percutaneous radiofrequenc y ablation of renal cell carcinoma has proved technically feasible, effecti ve, and safe in this patient. It may be offered as an alternative treatment to partial or radical nephrectomy under certain circumstances. Abbreviatio ns: RF=radiofrequency ablation; CT=computed tomography; HIV=human immunodef iciency virus.