BACKGROUND:Renal cell carcinomas (RCCs) are rarely described in transplanted kidneys.
Available therapeutic strategies range from allograft nephrectomy to nephron-sparing procedures such as partial nephrectomy or image-guided thermal ablation. Percutaneous radiofrequency ablation (RFA) is a minimally invasive technique which provides promising oncologic outcomes in small allograft RCCs while preserving allograft function. So far, only a few cases have been reported in the transplant setting. We describe a renal transplant RCC successfully approached by ultrasound-guided RFA.
METHODS: A 42-year-old renal transplant recipient developed a small subcapsular allograft RCC at 11 years after transplantation. The decline in glomerular filtration rare prompted us to preserve as much parenchyma as possible. Ultrasound-guided RFA was performed under light sedation and local analgesia in a single session with a Starbust Talon needle.
RESULTS: Postablation contrast-enhanced ultrasound displayed a 25×23 mm avascular area of complete necrosis. After 3 months gadolinium-enhanced magnetic resonance imaging confirmed the absence of viable tumor tissue and while the patient did not experience any graft function reduction (serum creatinine 2.6 mg/dL).
CONCLUSIONS: Image-guided RFA represents a promising therapeutic modality for small allograft RCCs in recipients with mild graft dysfunction and/or elevated surgical risk. It is associated with low morbidity and parenchymal preservation.
Written by:
Olivani A, Iaria M, Missale G, Capocasale E, Biasini E, Mazzoni MP, Lombardelli L, Luzi E, Frattini A, Pelosi G. Are you the author?
Division of Infectious Diseases and Hepatology, Parma University Hospital, Parma, Italy.
Reference: Transplant Proc. 2011 Dec;43(10):3997-9.
doi: 10.1016/j.transproceed.2011.08.089
PubMed Abstract
PMID: 22172886
