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Abstract
Symptomatic angiomyolipoma (AML) and asymptomatic AML larger than 4 cm in size are
usually treated with nephron-sparing surgery or arterial embolization. We used another
technique, that is, radiofrequency ablation (RFA), for treatment of a sporadic AML
in a patient with a solitary kidney, in whom maximal sparing of normal renal tissue
was required.
Contrast-enhanced computed tomography (CT) showed an enhancing well-defined mainly
lipomatous tumor, with a maximum diameter of 4.5 cm in the upper pole of the left
kidney. Diagnosis of AML was confirmed with fine-needle aspiration biopsy. RFA was
performed with a RF 3000 system, consisting of a generator that supplied up to 200W
of power, connected to a 15-gauge LeVeen multipolar array electrode that was placed
under CT-guidance centrally in the AML. Initial power was set at low power and increased
with increments of 10W, according to the algorithm provided by the manufacturer, resulting
in a final tumor end temperature above 65 degrees C. No complications occurred and
the patient was discharged home the day after. During follow-up (12 months) function
of the solitary kidney of the patient was preserved and patient did not have any AML-related
symptoms develop. Contrast-enhanced CT scan showed complete (100%) tumor ablation
with absence of enhancement in the tumor and decreased tumor size from 4.5 cm to 2.9
cm at 12 months.
CT-guided RFA is a minimally invasive ablation procedure that allowed successful treatment
of a sporadic AML in a patient with a solitary kidney. No complications occurred and
no AML recurrence was observed during the 12-month follow-up.