Gianpiero Cardone MD, Presenter: Nothing to Disclose

Andrea Cestari MD, Abstract Co-Author: Nothing to Disclose

Luciano Nava MD, Abstract Co-Author: Nothing to Disclose

Paola Mangili PhD, Abstract Co-Author: Nothing to Disclose

Giorgio Guazzoni MD, Abstract Co-Author: Nothing to Disclose

Giuseppe Balconi MD, Abstract Co-Author: Nothing to Disclose

The aim of his study is to determine the safety and efficacy of LC in the management of renal masses in patients affected by VHL RCC syndrome and HP RCC syndrome and to assess its medium term outcome after 4-year MR imaging follow-up.

5 pts affected by VHL RCC syndrome and 6 pts affected by HP RCC syndrome underwent LC of 29 tumors. All treatments were administered under laparoscopic US guidance. Pts were followed up clinically, biochemically and by MR imaging 24 hours after surgery, and subsequently at 1, 3, 6, 12, 18, 24, 36 and 48 months. All MR examinations were performed with a 1.5T MR system using GRE T1w, TSE T2w sequences with and without fat suppression (FS) and contrast-enhanced (ce) dynamic GRE FS-T1w sequence.

24 hours after treatment all cryolesions were more than 1 cm larger than the original masses; cryolesions decreased in size by an average of 38% at 1 month, 46% at 3 months, 64% at 6 months and 80% at 12 months following cryoablation. Early post-procedural MR ce-T1w images showed complete ischemia of all cryolesions, with relative hypointensity compared with normal renal parenchyma. Follow-up (mean 16 months, range 6 to 48 months) revealed no evidence of local recurrence in all the patients. One patient affected by VHL RCC syndrome demonstrated one metachronous nodule in the same kidney at 24 months. 4 pts affected by HP RCC syndrome showed 6 metachronous nodules 12-36 months after treatment. No significant rise in creatinine was noted post-procedurally in all the pts. After surgery retroperitoneal effusion was found in all the cases; 4/11 (36%) cases showed a small intralesional haematoma reabsorbed in the following controls.

Our medium term experience suggests that renal LC is a safe, well tolerated and minimally invasive therapy of renal masses in patients affected by VHL RCC syndrome and HP RCC syndrome, and MR is an effective imaging technique in the follow-up of renal lesions treated with LC.

LC is a safe and minimally invasive therapy for renal masses in pts affected by VHL RCC and HP RCC syndromes. MR is an effective imaging technique in the follow-up of renal lesions treated with LC

Cardone, G, Cestari, A, Nava, L, Mangili, P, Guazzoni, G, Balconi, G, Laparoscopic Cryoablation (LC) of Renal Masses in Patients Affected by Von Hippel Lindau RCC Syndrome and Hereditary Papillary RCC Syndrome: Medium Term Outcome after 4 Years Magnetic Resonance (MR) Imaging Follow-up.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5002338.html