Successful conservative management of colorenal fistula after percutaneous cryoablation of renal-cell carcinoma.

BACKGROUND: Cryoablation is an increasingly utilized treatment for renal-cell carcinoma. We describe the first reported case of colorenal fistula resulting from percutaneous renal cryoablation.

CASE REPORT: A 63-year-old man with hematuria was found to have an enhancing renal mass that was treated with percutaneous CT-guided cryoablation. Two months later, he presented with lower urinary-tract symptoms, and CT imaging revealed a colorenal fistula at the ablation site. Ureteral stent placement resulted in resolution of the fistula.

CONCLUSIONS: Contrary to previously reported animal and clinical studies, our case report demonstrates that it is possible to incur serious harm to the renal collecting system as a result of percutaneous renal cryoablation. In stable patients, an attempt at conservative management of a fistula should precede extensive reconstructive efforts.