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Percutaneous Cryoablation of Large Renal Masses: Technical Feasibility and Short-Term Outcome

Thomas D. Atwell1, Michael A. Farrell1, Matthew R. Callstrom1, J. William Charboneau1, Bradley C. Leibovich2, Igor Frank2 and David E. Patterson2

1 Department of Radiology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55902.
2 Department of Urology, Mayo Clinic, Rochester, MN.


Figure 1
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  		Fig. 1A —57-year-old woman with biopsy-proven renal cell carcinoma. Coronally reformatted contrast-enhanced CT scan shows 3.6-cm enhancing renal mass (arrow) in upper pole of right kidney.

 

Figure 2
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  		Fig. 1B —57-year-old woman with biopsy-proven renal cell carcinoma. Axial unenhanced CT scan shows ice ball developing around three cryoprobes (arrow). Catheter (arrowhead) for infusion of dextrose 5% in water displaces adjacent colon.

 

Figure 3
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  		Fig. 1C —57-year-old woman with biopsy-proven renal cell carcinoma. Coronally reformatted contrast-enhanced CT scan obtained immediately after ablation shows large ablation defect encompassing tumor.

 

Figure 4
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  		Fig. 1D —57-year-old woman with biopsy-proven renal cell carcinoma. Coronally reformatted contrast-enhanced CT scan obtained 3 months after ablation shows no residual or recurrent tumor and no evidence of collecting system injury.

 

Figure 5
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  		Fig. 2A —67-year-old man with renal mass and history of renal cell carcinoma. Contrast-enhanced axial CT scan shows 5.0-cm enhancing renal mass (arrows) in lower pole of right kidney.

 

Figure 6
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  		Fig. 2B —67-year-old man with renal mass and history of renal cell carcinoma. Axial unenhanced CT scans show evolution of ice ball around three cryoprobes over 24 minutes of freezing. Kidney has rotated with decubitus positioning.

 

Figure 7
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  		Fig. 2C —67-year-old man with renal mass and history of renal cell carcinoma. Axial unenhanced CT scans show evolution of ice ball around three cryoprobes over 24 minutes of freezing. Kidney has rotated with decubitus positioning.

 

Figure 8
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  		Fig. 2D —67-year-old man with renal mass and history of renal cell carcinoma. Axial unenhanced CT scans show evolution of ice ball around three cryoprobes over 24 minutes of freezing. Kidney has rotated with decubitus positioning.

 

Figure 9
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  		Fig. 2E —67-year-old man with renal mass and history of renal cell carcinoma. Axial contrast-enhanced CT scan obtained 7 months after ablation shows retraction of ablation site and no residual or recurrent tumor.

 

Figure 10
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  		Fig. 3A —84-year-old man with renal cell carcinoma in left kidney. Contrast-enhanced CT scan shows centrally located 4.0-cm mass (arrow) effacing renal pelvis.

 

Figure 11
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  		Fig. 3B —84-year-old man with renal cell carcinoma in left kidney. Contrast-enhanced CT scan 5 months after cryoablation shows gross residual tumor.

 

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