Late emergence of contrast-enhancing fat necrosis mimicking tumor seeding after renal cryoablation

J Vasc Interv Radiol. 2014 Jan;25(1):133-7. doi: 10.1016/j.jvir.2013.07.006.

Abstract

Defining radiographic treatment success after percutaneous renal ablation is challenging due to variable ablation zone imaging findings over time. The present report describes two cases of progressively more evident enhancing soft-tissue nodules in the perinephric fat more than 2 years after cryoablation. Despite features concerning for tumor recurrence on computed tomography and magnetic resonance imaging, biopsies revealed fat necrosis in both cases. Renal ablation zone soft-tissue nodules can appear long after ablation, enhance with contrast medium, mimic applicator tract or ablation zone tumor seeding, and may require biopsy for confirmation of benignity.

Keywords: RCC; RF; radiofrequency; renal cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Biopsy, Needle
  • Carcinoma, Renal Cell / diagnostic imaging
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / surgery*
  • Contrast Media*
  • Cryosurgery / adverse effects*
  • Diagnosis, Differential
  • Fat Necrosis / diagnostic imaging*
  • Fat Necrosis / etiology
  • Humans
  • Iohexol*
  • Kidney Neoplasms / diagnostic imaging
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery*
  • Magnetic Resonance Imaging*
  • Male
  • Multidetector Computed Tomography*
  • Neoplasm Seeding*
  • Organometallic Compounds*
  • Predictive Value of Tests
  • Time Factors
  • Treatment Outcome

Substances

  • Contrast Media
  • Organometallic Compounds
  • Iohexol
  • gadoversetamide