Percutaneous Renal Cryoablation of Angiomyolipomas in Patients With Solitary Kidneys

Abstract

To determine the feasibility and safety of performing percutaneous cryoablation of angiomyolipomas (AMLs) in patients with solitary kidneys. 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. 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. 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.