Successful conservative management of colorenal fistula after percutaneous cryoablation of renal-cell carcinoma.

BACKGROUND

Cryoablation is an increasingly utilized treatment for renal-cell carcinoma. We describe the first reported case of colorenal fistula resulting from percutaneous renal cryoablation.

CASE REPORT: A 63-year-old man with hematuria was found to have an enhancing renal mass that was treated with percutaneous CT-guided cryoablation. Two months later, he presented with lower urinary-tract symptoms, and CT imaging revealed a colorenal fistula at the ablation site. Ureteral stent placement resulted in resolution of the fistula.

CONCLUSIONS

Contrary to previously reported animal and clinical studies, our case report demonstrates that it is possible to incur serious harm to the renal collecting system as a result of percutaneous renal cryoablation. In stable patients, an attempt at conservative management of a fistula should precede extensive reconstructive efforts.