Radiofrequency ablation of large renal angiomyolipoma: median-term follow-up.

Abstract

PURPOSE:

To study the feasibility of percutaneous radiofrequency ablation (RFA) of large angiomyolipomas (AMLs) using saline-cooled electrodes.

MATERIALS AND METHODS:

Institutional Review Board approval for the study was received. Four patients (all female, age range 33-67 years) with large AMLs (maximal axis 6.1-32.4 cm) not suitable for embolotherapy or surgery consented to a trial of RFA. Procedures were performed under computerized tomographic guidance using 14G saline-infused electrodes. Two ablations (diameter 4-7 cm) were undertaken in each patient. Variables studied were technical success, treatment safety, alteration of tumor consistency, tumor size, effect on renal function, and medium-term freedom from haemorrhage.

RESULTS:

All four patients underwent successful RFA without any intraprocedural complications. There has been no haemorrhage, or new renal specific symptom, during a minimum 48-month period, and normal renal function has been normal. On follow-up radiological imaging, the tumors have become fattier with involution of the soft-tissue elements (soft tissue-to-total tumor ratio decreased mean [range] of 0.26 [0.14-0.48] to 0.17 [0.04-0.34] U; p = 0.04 [paired Student t test]). Further evidence of treatment effect was the development of a capsule around the ablation zone, but there was no change in overall tumor volume (mean [range] 1,120 [118-2,845] to 1150 [90-3,013] ml; p = 1 [paired Student t test]).

CONCLUSION:

RFA of large AMLs is technically feasible using saline-infused electrodes. The soft-tissue elements decreased in volume; the tumors become fattier; and there has been no renal haemorrhage during a 48-month period.

• Authors: S M Gregory, C J Anderson, U Patel
• Journal: Cardiovascular and interventional radiology (Cardiovasc Intervent Radiol) Vol. 36 Issue 3 Pg. 682-9 (Jun 2013) ISSN: 1432-086X [Electronic] United States
• PMID: 23354958 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Angiomyolipoma (pathology, surgery)
• Catheter Ablation (instrumentation, methods)
• Feasibility Studies
• Female
• Follow-Up Studies
• Humans
• Kidney Neoplasms (pathology, surgery)
• Middle Aged
• Radiography, Interventional
• Tomography, X-Ray Computed
• Treatment Outcome