Radical Nephrectomy Following Prior Cryoablation for Renal Cell Carcinoma: A Case Report and Literature Review.

INTRODUCTION

Small renal masses account for 48%-66% of renal cell carcinoma diagnoses, influencing management decisions for low-stage kidney disease. This report presents a case of cancer recurrence and tumor progression into the renal pelvis postcryoablation, managed with radical nephrectomy.

CASE PRESENTATION: A 70-year-old woman with a history of cryoablation for T1b renal cell carcinoma in the right kidney presented with persistent hematuria. Imaging revealed local recurrence and carcinoma invasion of the renal pelvis. The patient underwent open radical nephrectomy. Intraoperatively, the kidney was found adhered to the peritoneum and vena cava. The remaining elements of renal, hilar and adrenal anatomy showed no abnormalities. The postoperative course was uneventful.

CONCLUSION

While local recurrences following cryoablation can often be safely retreated with cryoablation, progression involving the renal pelvis is rare and demands heightened vigilance and expertise. Tailored approaches, including radical nephrectomy and technical adaptability, are essential for achieving optimal oncological and functional outcomes.