Radiofrequency ablation (RFA) therapy for renal angiomyolipoma (AML)

An alternative to angio-embolization and nephron-sparing surgery

Scott M. Castle, Vladislav Gorbatiy, Obi Ekwenna, Ezekiel Young, Raymond J. Leveillee

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

OBJECTIVES To show that radiofrequency ablation (RFA) is safe and effective treatment for renal angiomyolipoma (AML). Current treatments to reduce the risk of haemorrhage include tumour extirpation, angio-embolization, or ablative therapy. PATIENTS AND METHODS Review of our prospective database revealed 15 patients with intraoperative biopsy confirmed renal AML undergoing RFA from February 2002 to March 2010. Patients underwent either laparoscopic or computed tomography (CT)-guided percutaneous RFA using either the Cool-tip™ (Covidien, Inc. Boulder, CO, USA) or RITA™ (Angiodynamics®, Latham, NY, USA) RFA probe. CT at 1 month, 6 months, 1 year, and annually thereafter. RESULTS In all, two male and 13 female patients with seven left-sided and eight right-sided tumours with a mean (range) size of 2.6 (1.0-3.7) cm underwent laparoscopic (five) or CT-guided (10) RFA. No intraoperative complications occurred. Minor complications included transient haematuria and intercostals nerve transection. Surgical complications included pneumonia and myocardial infarction. There was no radiographic evidence of persistent AML (CT enhancement) at a mean follow-up of 21 months. CONCLUSIONS The haemostatic effect of RFA allows renal lesions suspicious for AML to be treated without bleeding complications. Avoids surgical risk of extirpation or embolization. RFA for renal AML is safe and effective.

Original languageEnglish
Pages (from-to)384-387
Number of pages4
JournalBJU International
Volume109
Issue number3
DOIs
StatePublished - Feb 1 2012
Externally publishedYes

Fingerprint

Angiomyolipoma
Nephrons
Kidney
Tomography
Intercostal Nerves
Hemorrhage
Therapeutics
Intraoperative Complications
Hematuria
Hemostatics
Carbon Monoxide
Neoplasms
Pneumonia
Myocardial Infarction
Databases
Biopsy

Keywords

  • ablation
  • angiomyolipoma (AML)
  • haemorrhage
  • renal

ASJC Scopus subject areas

  • Urology

Cite this

Radiofrequency ablation (RFA) therapy for renal angiomyolipoma (AML) : An alternative to angio-embolization and nephron-sparing surgery. / Castle, Scott M.; Gorbatiy, Vladislav; Ekwenna, Obi; Young, Ezekiel; Leveillee, Raymond J.

In: BJU International, Vol. 109, No. 3, 01.02.2012, p. 384-387.

Research output: Contribution to journalArticle

Castle, Scott M. ; Gorbatiy, Vladislav ; Ekwenna, Obi ; Young, Ezekiel ; Leveillee, Raymond J. / Radiofrequency ablation (RFA) therapy for renal angiomyolipoma (AML) : An alternative to angio-embolization and nephron-sparing surgery. In: BJU International. 2012 ; Vol. 109, No. 3. pp. 384-387.
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AB - OBJECTIVES To show that radiofrequency ablation (RFA) is safe and effective treatment for renal angiomyolipoma (AML). Current treatments to reduce the risk of haemorrhage include tumour extirpation, angio-embolization, or ablative therapy. PATIENTS AND METHODS Review of our prospective database revealed 15 patients with intraoperative biopsy confirmed renal AML undergoing RFA from February 2002 to March 2010. Patients underwent either laparoscopic or computed tomography (CT)-guided percutaneous RFA using either the Cool-tip™ (Covidien, Inc. Boulder, CO, USA) or RITA™ (Angiodynamics®, Latham, NY, USA) RFA probe. CT at 1 month, 6 months, 1 year, and annually thereafter. RESULTS In all, two male and 13 female patients with seven left-sided and eight right-sided tumours with a mean (range) size of 2.6 (1.0-3.7) cm underwent laparoscopic (five) or CT-guided (10) RFA. No intraoperative complications occurred. Minor complications included transient haematuria and intercostals nerve transection. Surgical complications included pneumonia and myocardial infarction. There was no radiographic evidence of persistent AML (CT enhancement) at a mean follow-up of 21 months. CONCLUSIONS The haemostatic effect of RFA allows renal lesions suspicious for AML to be treated without bleeding complications. Avoids surgical risk of extirpation or embolization. RFA for renal AML is safe and effective.

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