PMC3643323_01
Contrast-enhanced CT scan depicting renal mass or ablation site (white arrow). (a) Pre-op 4.3-cm renal mass. (b) MWA post-op scan showing ablated tumor. (c) MWA post-op film showing recurrence at anterior portion of ablation zone. (d) RFA post-op scan shows no residual disease at 24 months
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F1
He presented with a 4.33-cm lower pole tumor of his solitary right kidney diagnosed via contrast-enhanced computed tomography (CT) scan [Figure 1a] and came to our facility for evaluation. The patient had an uneventful postoperative course, and was followed with a contrast-enhanced CT scan at 1 month [Figure 1b] and at 4 months [Figure 1c]. The scan performed at 4 months post-op showed nodular thickening with enhancement at the ablation site read as recurrence [Figure 1d].
Laparoscopic picture showing the ablation probes (white arrows) and peripheral fiber-optic temperature monitors (green arrows). The original MWA is shown on the left while the RFA is shown on the right
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F2
The microwave antenna was advanced into the tumor [Figure 2] and MWA commenced with simultaneous peripheral fiber-optic thermometry (Lumasense, Santa Clara, CA, USA) to determine treatment endpoints of >60 C. Three 3.0-cm Cooltip  RFA probes (Covidien Inc.) were positioned in a triangular array with peripheral thermometry as described above [Figure 2].