Two-probe MWA of RCC lesions in different locations

A 70-Year-old obese female patient diagnosed with cystic RCC in 2016 was treated with surgery. In 2023 a small local recurrence near the abdominal wall was detected and a new lesion near the renal hilum also appeared. The MDT decided for a CT- guided double microwave ablation assisted with CAS-One IR to ensure a quick, accurate procedure.

Planning scan with the 2 trajectories in MPR view

 Screenshot_10_08_29_SN1_000002

Needle verification image in MPR showing actual ablation zone with respect to needle position

 1-lession
Follow-up scan showing full treatment of the first lesion (left), compared to the planning scan (right)
 
 
2-lesion
Follow-up scan showing full treatment of the second lesion (left) compared to the planning scan (right)
 

Name: Dr. Ádám Zoltán Farkas


Institution: Semmelweis University, Budapest, Hungary


Patient sex:  Female 


Initial condition:

  • Patient was initially diagnosed with a cystic Renal Cell Carcinoma on the left kidney in 2016. 
  • Patient underwent open surgery with a lumbotomy approach and was tumor-free until 2023.
  • In January 2023, a follow-up MRI showed a small local recurrence of 15mm. A new lesion of 23.5 x 20.5mm was also detected near the hilum.
  • The MDT decided for a double microwave ablation under CT guidance because of its difficult location and visibility due to the patient's obesity. 
  • CAS-One IR was chosen in this case because of the proximity of the second tumor to the hilum and renal artery which required precise planning and navigation.

Treatment: 

  • Both lesions were treated with MWA using the ECO system.
  • The planning of CAS-One IR also enabled the physician to spare as much of healthy tissue as possible.
  • CAS-One IR was chosen to ensure the maximum accuracy due to the challenging location of the new lesion.
  • Complete ablation of the tumors and clinical margin was observed.
  • The patient experienced no complications during the procedure and was released the next day.

Result:

  • This difficult trajectory was safely planned and placed using CAS-One IR navigation capabilities, avoiding damage to the artery or ureter.
  • Two months follow-up MRI showed complete treatment of the lesions and no local recurrence at both of the ablative sites.
  • The physician was very pleased with the use of CAS-One IR in this challenging case due to the location of the lesion and the obesity of the patient which made ultrasound-guided ablation impossible. CAS-One IR ensured safety and ablation confirmation for a complete treatment.

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

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