Clinical Case
62 y old male with a history of right nephrectomy due to renal cell carcinoma in 2019 and radiofrequency ablation of a lower pole tumor in the left kidney in 2020 was diagnosed of local remnant of left kidney cancer on continuous follow-up CT imaging.
CT imaging found local tumor remnant in a lover pole of left kidney representing incomplete ablation probably related to insufficient guidance (primary treatment was performed under ultrasound guidance) (picture 1).
Patient had no clinical symptoms. Renal function was sustained despite previous surgical history.
Since primary tumor ablation was performed under ultrasound guidance multidisciplinary team decision was to perform CT guided tumor ablation.
Procedure
CT guided microwave ablation was performed after contrast enhanced CT during the ablation procedure to get the best treatment plan. Procedure was performed under general anesthesia with patient lying right decubitus position.
Renal tumor microwave ablation was performed using 14 gauge 15 centimeters single microwave antenna (Tato, Biomedical Srl) applying 35 W of energy for 15 minutes (picture 2).
No specific focal area preparation was made since tumor was located in lateral part of lower kidney pole with a safe distance from pelvicalyceal system.
Follow up/Conclusion
Patient was dispatched home the next day after the procedure without any clinical symptoms. One month after the procedure the patient was in a good condition regarding renal function. On contrast enhanced ultrasound only avascular area was seen without any viable tumor remnant.
Products used
TATOpro antenna , 14 gauge x 15 cm item code TTP1415CDCM
