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  • Title: Percutaneous renal cryoablation of angiomyolipomas in patients with solitary kidneys.
    Author: Johnson SC, Graham S, D'Agostino H, Elmajian DA, Shingleton WB.
    Journal: Urology; 2009 Dec; 74(6):1246-9. PubMed ID: 19815260.
    Abstract:
    OBJECTIVES: To determine the feasibility and safety of performing percutaneous cryoablation of angiomyolipomas (AMLs) in patients with solitary kidneys. METHODS: Three patients with AMLs involving a solitary kidney underwent computed tomography-guided percutaneous cryoablation. All lesions were located in the lateral/posterior part of the kidney, allowing for safe access from the skin for cryoprobe insertion. Intravenous sedation and local anesthesia were used for each patient. Follow-up computed tomography or magnetic resonance imaging and physical examination, urinalysis, and serum blood urea nitrogen/creatinine measurement were performed to evaluate for lesion recurrence and to evaluate the safety profile. RESULTS: Three tumors (1.2-2.5 cm) were treated. The patients experienced minimal to no pain during percutaneous cryoablation, and all were discharged the same day. No procedural or postoperative complications were noted. During the follow-up period (5-36 months), the first 2 patients had no radiographic evidence of recurrence. Initial follow-up imaging of the third patient displayed persistent AMLs. CONCLUSIONS: A review of the published data suggested the necessity to prophylactically treat AMLs of solitary kidneys. In this series, percutaneous cryoablation proved a safe and effective method for treating these lesions. This ultimately provides a minimally invasive option for similar patients, potentially avoiding an open surgical procedure or the risk of hemorrhage.
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