Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus

This is a case of a 78-year-old male patient with multiple angiomyolipomas of a solitary right kidney. The largest of these tumors (maximum diameter: 13.4 cm) caused significant extrinsic compression of the inferior vena cava complicated by thrombosis of this vessel. Treatment of thrombosis with ant...

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Main Authors: Konstantinos N. Stamatiou, Hippocrates Moschouris, Kiriaki Marmaridou, Michail Kiltenis, Konstantinos Kladis-Kalentzis, Katerina Malagari
Format: Article
Language:English
Published: Hindawi Limited 2016-01-01
Series:Case Reports in Oncological Medicine
Online Access:http://dx.doi.org/10.1155/2016/8087232
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spelling doaj-d6704e0842ba460da4c9c0dad9031d852020-11-24T23:01:09ZengHindawi LimitedCase Reports in Oncological Medicine2090-67062090-67142016-01-01201610.1155/2016/80872328087232Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval ThrombusKonstantinos N. Stamatiou0Hippocrates Moschouris1Kiriaki Marmaridou2Michail Kiltenis3Konstantinos Kladis-Kalentzis4Katerina Malagari5Department of Urology, Tzaneio General Hospital, 18536 Piraeus, GreeceDepartment of Diagnostic and Interventional Radiology, Tzaneio General Hospital, 18536 Piraeus, GreeceDepartment of Diagnostic and Interventional Radiology, Tzaneio General Hospital, 18536 Piraeus, GreeceDepartment of Diagnostic and Interventional Radiology, Tzaneio General Hospital, 18536 Piraeus, GreeceDepartment of Diagnostic and Interventional Radiology, Tzaneio General Hospital, 18536 Piraeus, Greece2nd Department of Radiology, University of Athens, Attikon Hospital, Chaidari, 12462 Athens, GreeceThis is a case of a 78-year-old male patient with multiple angiomyolipomas of a solitary right kidney. The largest of these tumors (maximum diameter: 13.4 cm) caused significant extrinsic compression of the inferior vena cava complicated by thrombosis of this vessel. Treatment of thrombosis with anticoagulants had been ineffective and the patient had experienced a bleeding episode from the largest right renal angiomyolipoma, which had been treated by transarterial embolization in another institution, 4 months prior to our intervention. Our approach included superselective transarterial embolization of the dominant, right kidney angiomyolipoma with hydrogel microspheres, which was combined, 20 days later, with ultrasonographically guided radiofrequency ablation. Both interventions were uneventful. Computed tomography 2 months after ablation showed a 53% reduction in tumor volume, reduced space-occupying effect on inferior vena cava, and resolution of caval thrombus. Nine months after intervention the patient has had no recurrence of thrombosis or hemorrhage and no tumor regrowth has been observed. The combination of superselective transarterial embolization and radiofrequency ablation seems to be a feasible, safe, and efficient treatment of large renal angiomyolipomas.http://dx.doi.org/10.1155/2016/8087232
collection DOAJ
language English
format Article
sources DOAJ
author Konstantinos N. Stamatiou
Hippocrates Moschouris
Kiriaki Marmaridou
Michail Kiltenis
Konstantinos Kladis-Kalentzis
Katerina Malagari
spellingShingle Konstantinos N. Stamatiou
Hippocrates Moschouris
Kiriaki Marmaridou
Michail Kiltenis
Konstantinos Kladis-Kalentzis
Katerina Malagari
Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus
Case Reports in Oncological Medicine
author_facet Konstantinos N. Stamatiou
Hippocrates Moschouris
Kiriaki Marmaridou
Michail Kiltenis
Konstantinos Kladis-Kalentzis
Katerina Malagari
author_sort Konstantinos N. Stamatiou
title Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus
title_short Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus
title_full Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus
title_fullStr Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus
title_full_unstemmed Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus
title_sort combination of superselective arterial embolization and radiofrequency ablation for the treatment of a giant renal angiomyolipoma complicated with caval thrombus
publisher Hindawi Limited
series Case Reports in Oncological Medicine
issn 2090-6706
2090-6714
publishDate 2016-01-01
description This is a case of a 78-year-old male patient with multiple angiomyolipomas of a solitary right kidney. The largest of these tumors (maximum diameter: 13.4 cm) caused significant extrinsic compression of the inferior vena cava complicated by thrombosis of this vessel. Treatment of thrombosis with anticoagulants had been ineffective and the patient had experienced a bleeding episode from the largest right renal angiomyolipoma, which had been treated by transarterial embolization in another institution, 4 months prior to our intervention. Our approach included superselective transarterial embolization of the dominant, right kidney angiomyolipoma with hydrogel microspheres, which was combined, 20 days later, with ultrasonographically guided radiofrequency ablation. Both interventions were uneventful. Computed tomography 2 months after ablation showed a 53% reduction in tumor volume, reduced space-occupying effect on inferior vena cava, and resolution of caval thrombus. Nine months after intervention the patient has had no recurrence of thrombosis or hemorrhage and no tumor regrowth has been observed. The combination of superselective transarterial embolization and radiofrequency ablation seems to be a feasible, safe, and efficient treatment of large renal angiomyolipomas.
url http://dx.doi.org/10.1155/2016/8087232
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