De Novo Renal Tumors Arising in Kidney Transplants: Midterm Outcome after Percutaneous Thermal Ablation

Abstract

Purpose:To retrospectively evaluate the midterm outcome of patients treated for primary renal cell carcinomas arising in kidney transplants with minimally invasive techniques. Materials and Methods:The institutional review board of each participating institution approved this retrospective study and waived informed consent . This study was HIPAA compliant. A request for cases through the European Society of Urogenital Radiology network was made to institutions for patients who fi t the requirements outlined by the authors, and a prospective follow-up of recipients was performed. Twenty-four tumors were identifi ed that developed in the renal allograft of 20 patients from 11 institutions who were treated with radiofrequency ablation ( n = 19) or cryoablation ( n = 5) between 2003 and 2010. Maximal diameter of masses was 6-40 mm (median, 19.5 mm). Twenty masses were solid, and four were type 4 cystic masses. Preablation biopsy was performed for solid tumors only. All images and biologic and biopsy reports were retrospectively reviewed. Significant differences were determined by using a paired t test before and after ablation. Results:Mean follow-up was 27.9 months (range, 7-71 months). Histopathologic examination revealed papillary carcinoma in 17 patients and clear cell carcinoma in three. Tumors were successfully treated with ultrasonographic guidance in six patients, with computed tomographic guidance in 10 patients, and with both in four patients. One case of infection of the tumor site and one case of transitory genitofemoral nerve injury were the only reported complications.No signifi cant change of renal function was noted. Subsequent imaging follow-up did not reveal any case of recurrence in the ablative site. Conclusion:Percutaneous thermal ablation of renal tumors occurring in renal grafts is effective, with low morbidity.q RSNA, 2011

Cryoablation for Small Renal Masses: Selection Criteria, Complications, and Functional and Oncologic Results

“…Studies have shown that CA in this subgroup represents an attractive option as the primary treatment modality or after recurrence following PN [40,41]. Another special indication for CA may include patients with a solitary or transplanted kidney, especially when presenting with recurrent disease [42,43]. The minimally invasive nature of CA, in particular the E U R O P E A N U R O L O G Y X X X ( 2 0 1 5 ) X X X -X X X percutaneous route, and maximal preservation of renal function are the cited advantages of this approach.…”

Cryoablation and Meriva have strong therapeutic effect on triple-negative breast cancer

“…[18][19][20][21] Cryoablation involves the insertion of a probe into a tumor nodule in order to administer tissue ablative freezing temperatures, which will lead to immediate disruption of the tissue structure and cellular damage. 22 The necrosis observed in the ablated lesion is mediated by mechanical disruption from crystallization, osmotic changes, and vascular stasis.…”

Management of Renal Masses in Transplant Allografts at an Australian Kidney-Pancreas Transplant Unit

“…Patients were treated for small, exophytic masses consistent with current practice for native kidney tumors. Cornelius et al demonstrated robust mid-term oncologic efficacy in the largest series of allograft tumors treated by RFA (n=24) and no significant worsening of renal function (25). Our patient is, to our knowledge, the first report of large multifocal allograft RCC disease managed with RFA.…”