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

 

 

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.