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Case Reports
. 2022 Apr 8;17(6):2014-2017.
doi: 10.1016/j.radcr.2022.03.061. eCollection 2022 Jun.

A case of percutaneous cryoablation complicated by subcapsular hemorrhage managed conservatively

Alexandra M Dubinin  1 , Gerant Rivera-Sanfeliz  2 , Ithaar Derweesh  3 , David Duncan  4
Affiliations
Case Reports

A case of percutaneous cryoablation complicated by subcapsular hemorrhage managed conservatively

Alexandra M Dubinin et al. Radiol Case Rep. .

Abstract

Herein, we report a patient who underwent percutaneous cryoablation for suspected renal cell carcinoma and developed a subcapsular hematoma with numerous pseudoaneurysms and dramatic structural deformity. Despite the severity suggested by the radiologic presentation, a conservative management approach was selected due to the patient's favorable hemodynamic status. This resulted in a positive outcome as alternative treatment options would have resulted in loss of the organ.

Keywords: Cryoablation; RCC, Renal cell carcinoma; Renal cell carcinoma; Subcapsular hematoma.

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Figures

Fig 1
Fig. 1
(A) Axial contrast enhanced CT image in nephrographic phase demonstrating a 2.7 cm, homogeneously enhancing renal mass in the right kidney. (B) Cross-sectional image demonstrating cryosection probe in place during second freeze cycle that shows an ice ball covering the treated mass with no significant perirenal hematoma.
Fig 2
Fig. 2
(A) Coronal CT with contrast on post-op day #1 shows a large subcapsular hematoma and renal lacerations associated with multiple pseudoaneurysms. (B) Early arterial phase selective right renal arteriogram demonstrates innumerable subcapsular pseudoaneurysms in the interpolar and lower pole regions, as well as suspicious areas of extravasation in the upper pole region (C) Late arterial phase selective right renal arteriogram confirms areas of extravasation peripherally throughout the entire kidney, some at a considerable distance from the ablation zone.
Fig 3
Fig. 3
Coronal CT with contrast at 6-week follow-up which demonstrates a decrease in size of the subcapsular hematoma with interval resolution of the pseudoaneurysms.
See this image and copyright information in PMC

References

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