CT-guided radiofrequency ablation of pediatric Wilms tumor in a solitary kidney

Abstract

Although recent results of percutaneous imaging-guided radiofrequency ablation (RFA) of various tumors in adults are promising, RFA of tumors in children has been performed in only a small number of cases. We describe the treatment of Wilms tumor in a solitary kidney in a 5-year-old girl using percutaneous CT-guided RFA. The procedure provided short-term palliation in this child for whom partial or total nephrectomy carried high risk and low likelihood of success. Although it might only be useful ultimately as a temporizing measure, oncologists and surgeons might wish to consider RFA in children who would otherwise require dialysis and renal transplantation or who are poor surgical candidates. Various specific technical issues differentiate pediatric from adult tumor ablation, including the amount of intra-abdominal fat, need for smaller grounding pads, and potential systemic effects of tissue heating.