Radiofrequency ablation of small symptomatic angiomyolipomas of the kidney: Report of two cases

Abstract

Background: The development of more sensitive imaging techniques caused an increase in the number of diagnosed small renal tumors. The small size of the lesions allows for their treatment with minimally invasive nephron-sparing methods. Approximately 2-3% of these lesions are proved to be angiomyolipomas (AML). AML is a rare benign tumor of the kidney, sometimes causing pain and hematuria. The most commonly required approach is observation but in case of recurrent symptoms or larger tumors which may cause bleeding, a more active treatment is needed. This paper demonstrated the evolution of our attitude leading to utilization of radiofrequency ablation (RFA) as a minimally invasive option in the management of small symptomatic AMLs of the kidneys.

Material/methods: We presented clinical data of two cases of symptomatic AML tumors in the kidney, treated with RFA. The tumors were diagnosed on the basis of a contrast-enhanced CT (computed tomography) scan. The probe was inserted into the lesion percutaneously under USG (ultrasonography) guidance.

Results: RFA proved to be an effective and safe method of treatment of renal AMLs. A follow-up carried out after 1.5 and 3 years, basing on contrast-enhanced CT tests, confirmed a complete ablation of the AML and decreased tumor size.

Conclusions: Promising results of RFA in the management of AML may encourage urologists and radiologists to use this minimally invasive technology and to qualify patients for this treatment more often and thus to prevent potential complications in the future.

Keywords: RFA; angiomyolipoma of the kidney; minimally invasive treatment.

Figure 1.

CT in a 57-year-old patient with AML in the kidney before RFA. A lesion of 23 mm, in the right kidney, revealing AML features and a strong contrast enhancement.

Figure 2.

CT at one year and six months after RFA. The same lesion, presenting no contrast enhancement.