Safe renal tumor ablation using perinephric fat hydrodissection to displace the colon: a 12-month imaging follow-up in a high-risk oncology patient

Purpose: The purpose of this case report is to highlight the successful use of percutaneous renal ablation combined with hydrodissection of perinephric fat to safely displace the colon and achieve effective tumor control in a high-risk oncology patient with multiple comorbidities. This technique offers a potential solution for patients with renal masses located near critical structures, such as the gastrointestinal tract, where thermal injury is a significant concern. Case Summary: A 78-year-old female patient with a history of coronary artery disease and previous breast cancer was referred for management of an incidental renal mass. Initial imaging revealed a 2,2 cm enhancing mass located in the left kidney, with a distance of approximately 1,4 mm from the descending colon. Given her complex medical history, including ischemic heart disease and advanced age, she was deemed high-risk for surgery. Due to the tumor’s proximity to the colon, a decision was made to proceed with image- guided radio frequency ablation (RFA), incorporating a hydrodissection technique to ensure safe tumor ablation without compromising surrounding tissues. Conclusion: This case illustrates the efficacy of using hydrodissection in conjunction with radiofrequency ablation to treat renal tumors located near critical structures, such as the colon. The technique allowed for safe tumor ablation without thermal injury to the surrounding organs, providing a successful outcome in a high-risk patient. The 12-month imaging follow-up showed complete tumor necrosis, demonstrating the potential of this approach in enhancing the safety and efficacy of percutaneous renal tumor ablation.