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Case Reports in Oncological Medicine
Volume 2016, Article ID 8087232, 5 pages
http://dx.doi.org/10.1155/2016/8087232
Case Report

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

1Department of Urology, Tzaneio General Hospital, 18536 Piraeus, Greece
2Department of Diagnostic and Interventional Radiology, Tzaneio General Hospital, 18536 Piraeus, Greece
32nd Department of Radiology, University of Athens, Attikon Hospital, Chaidari, 12462 Athens, Greece

Received 17 November 2015; Accepted 13 April 2016

Academic Editor: Cesar V. Reyes

Copyright © 2016 Konstantinos N. Stamatiou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.