Bi-lateral Ablations of multiple, large Renal Lesions

Bi-lateral Ablations of multiple, large Renal Lesions


Bi-lateral ablations of multiple renal lesions with CAS-One IR in two sessions. Comprehensive planning of large ablations combined with a high accuracy in needle placement resulted in reduced intervention times. This helped to preserve the quality of life of the patient.

Combined videosequence of treatment planning and ablation confirmation of the right kidney

Case Haifa Confirmation Overview3-month post intervention imaging of the right kidney

Case Haifa Planning OverviewTreatment planning of the microwave ablations in the left kidney

Name: Dr. Nadia Brezgalin and Dr. Natalia Goldberg

Institution: Carmel Medical Center, Haifa (Israel)

Patient age and sex: 72 years, male

Initial condition:

  • Family history of urinary tract issues, renal cell carcinoma and breast cancer
  • Patient is a smoker and has hypertension
  • Unintentional weight loss triggered CE-CT scan, showing several lesions in both kidneys, the largest about 5 cm in the left kidney
  • Biopsy revealed chromophobe RCC
  • Laparoscopic partial resection of the large lesion in the left kidney. The course of the surgery was technically difficult considering severe adhesions and difficulty in separating the lesion as well as significant bleeding during resection. Therefore, it was decided not to proceed with the resection of an additional lesion. Two papillary findings were also identified
  • Nephrostomy unsuccessful due to bleeding
  • Resection of bladder tumour and removal of an urethral suppository


  • MWA of four large lesions in the right kidney: Treatment was conducted with CAS-One IR because of its advanced planning capabilities, that allowed treatment of all four lesions in one session. Freehand would only be an option for treatment of 1 -2 lesions per session
  • MWA of the two remaining lesions in the left kidney after unsuccessful partial nephrectomy


  • Three month post ablation of the right kidney shows significant reduction of the over all tumour mass – Physicians were very pleased with the result of this palliative treatment
  • The large 5 cm lesion in the left kidney shows good response to the microwave ablation on the post intervention scan
  • The 2nd lesion in the left kidney remained untreated. The hard, fibrotic scar tissue after attempted surgery prevented penetration with the ablation needle
  • The patient awaits follow up under oncological supervision

Learn more about the stereotactic navigation system CAS-One IR.

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