Percutaneous radiofrequency ablation of renal cell carcinomas in patients with von Hippel Lindau disease: indications, techniques, complications, and outcomes

Abstract

Renal cell carcinoma (RCC) in patients with von Hippel Lindau (VHL) disease tends to be multifocal, bilateral, and recur or develop new tumors after removal. These characteristics make treating hereditary RCCs difficult for urologists or radiologists compared to treating a sporadic RCC. Radiofrequency ablation (RFA) is a minimally-invasive treatment for small hereditary RCCs associated with a low complication rate and a minimal decrease in renal function. No RFA guidelines have been established about what to treat and when and how to ablate RCCs in patients with VHL disease. Besides, reports on complications and treatment outcomes in this patient group are rare. The purpose of this review is to discuss the indications, techniques, complications, and outcomes of RFA in treating RCC in patients with VHL disease.

Hereditary renal cell carcinoma syndromes: diagnosis, surveillance and management

“…In particular, a consensus has developed that small (< 3 cm) screen-detected tumours should be managed by active surveillance and then nephron-sparing surgery performed when a solid lesion reaches 3 cm in diameter [ 47 ]. As an alternative to partial nephrectomy percutaneous radiofrequency ablation has been used to treat small renal lesions in VHL disease [ 51 ]. In general, the approach to the management of RCCs identified through surveillance in VHL disease has been extrapolated to individuals with Birt–Hogg–Dube syndrome with tumours followed by active surveillance until they reach a diameter of 3 cm and then nephron-sparing surgery is performed (alternatively, radiofrequency ablation may be used to treat smaller tumours) [ 13 ].…”

CT-Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma in Korea: Mid-Term Outcomes

“…Subsequently, renal function is minimally, but significantly, reduced when treating a single RCC with RFA. Increasing number of RCCs to be ablated may exacerbate the renal function reduction, which has been shown when treating recurrent RCC in patients with von-Hippel-Lindau disease (18,19,20). RCC size and location may also influence renal function change.…”

Intermittent everolimus administration for renal angiomyolipoma associated with tuberous sclerosis complex

“…If the AML grows larger after the withdrawal of everolimus treatment, it is necessary to repeat the treatment. Percutaneous cryoablation and radiofrequency ablation are carried out for multiple renal carcinomas associated with von Hippel–Lindau disease and TSC‐AML . These treatments involve minimal invasion of the living body and can be repeatedly carried out.…”