Renal Tumor Ablation
The diagnosis of solid renal mass is becoming more common as we perform CT scans and MRIs for a variety of reasons. These lesions are often asymptomatic and discovered incidentally. However, once they are discovered, the question of what to do next is inevitable.
The majority of these masses, unfortunately, are malignant. However, up to 20-30% of these lesions, are not a renal malignancy, and knowing the pathology can help dictate available therapeutic options. A biopsy is typically performed to differentiate benign vs malignant masses, and is done as an outpatient procedure under conscious sedation.
In the event that the mass is a renal cancer, there are a variety of options available to manage this type of cancer. Often, for very small lesions < 1cm, just following the lesion is appropriate. These are often slow growing tumors, and may never become clinically relevant. For lesions < 3cm in size, depending on location, they may be best addressed with nephrectomy (removal of the kidney), partial nephrectomy (remove part of the kidney) or percutaneous ablation. The first two options are performed by a Urologist, and would be best to discuss the risks vs benefits for this type of approach with your urologist.
Renal ablation is the use of thermal energy, either cold or heat, to kill the cancer cells. For small lesions, this approach is considered an acceptable alternative to surgery. This procedure is performed with imaging guidance, either CT or ultrasound, which is used to advance a small needle into the mass. Typically, general anesthesia is used for this procedure. Once the needle is in the lesion, energy is deposited in a very calculated manner until the entire lesion is ablated (destroyed).
Recovery is typically easy with 3-4 hours of bed rest and going home the same day. Pain is often no different than the biopsy which is easily controlled with OTC pain medicines. A follow up imaging study, usually CT or MRI, with clinic appointment, is performed 1 month after the procedure and repeated every 3 months for the first year, every 6 months for the second year, and yearly until we are 5 years out from treatment.
If you, a family member or friend has been diagnosed with a renal mass, we would be happy to see you in clinic to discuss potential treatment options.