S. Nahum Goldberg

RADIO FREQUENCY ABLATION OF RENAL CELL CARCINOMA VIA IMAGE GUIDED NEEDLE ELECTRODES

An 84-year-old man was diagnosed with a solid renal mass and he refused open surgery. Computerized tomography (CT) demonstrated mass enhancement with iodinated contrast material, consistent with solid renal cell carcinoma (fig. 1). Three years later the mass had enlarged to 3.5 cm. The patient continued to refuse surgery but he consented to perxad cutaneous radio frequency ablation. Institutional review board permission was obtained before the procedure. The patient underwent conscious sedation with 2 mg. mixad dazolam and 150 mg. fentanyl given intravenously as well as 1% lidocaine given subcutaneously. Immediately before abxad lation percutaneous needle biopsy confirmed the diagnosis of renal cell carcinoma. A 17 gauge, internally cooled radio frequency needle electrode was placed percutaneously under real-time ultrasound guidance into the center of the lesion. Goldberg1 and Solbiati2 et al have shown that these elecxad trodes induce large volumes of coagulation necrosis in liver tumors. The tumor was heated to 90C for 1 minute, followed by deposition of 1,200 mA. for 12 minutes. Ultrasonography revealed progressive hyperechogenicity enveloping the lesion during treatment. After ablation temperatures remained at greater than 60C for 3.5 minutes. The electrode was removed without incident.