Case Report of International Journal of Case Reports
Colo-renal fistula following percutaneous radiofrequency ablation of a renal tumor. A case report and review of treatment options
Allan Stolarski, MD1,2, Joanna Wang, MD1,2, Katherine He, MD1,3, Lori Lerner, MD1,2, Gentian Kristo, MD1,3
1Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA, USA; 2Department of Surgery, Boston Medical Center, Boston University Medical School, Boston, MA, USA; 3Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.
Background: Colo-renal fistula formation is a very rare complication following percutaneous radiofrequency ablation (RFA) in the management of renal cell carcinoma. In this paper we describe the management of a patient with a left colo-renal fistula occurring after renal tumor RFA. Additionally, we present a thorough literature review of reported cases of colo-renal fistulae after percutaneous RFA to further highlight their treatment challenges.
Summary: Two weeks after undergoing percutaneous RFA of an incidental 3cm left renal mass, a 67-year-old male was re-admitted to the hospital with a symptomatic colo-renal fistula. Patient ultimately failed conservative management with broad spectrum antibiotics and ureteral stent placements, and subsequently underwent segmental colonic resection and renorrhaphy, with complete renal preservation.
Conclusion: Although complications after RFA of renal tumors are rare, iatrogenic colo-renal fistula formation is a significant complication requiring a multi-disciplinary approach with a trial of non-operative management prior to surgical intervention.
Keywords: renal cancer; radiofrequency ablation, colorenal fistula
How to cite this article:
Allan Stolarski, Joanna Wang, Katherine He, Lori Lerner, Gentian Kristo. Colo-renal fistula following percutaneous radiofrequency ablation of a renal tumor. A case report and review of treatment options. International Journal of Case Reports, 2020 4:139. DOI: 10.28933/ijcr-2020-06-0405
1. Medina SJ, González RE, Hernández-Atance JM et al. Renocolic fistula as a complication of radiofrequency in the treatment of renal cell carcinoma. Arch Esp Urol. 2010 Jan-Feb;63(1):74-7.
2. Patel BJ, Mathur AK, Puri N, Jackson CS. A Rare Case of Nephrocolic Fistula Resulting from Radiofrequency Ablation (RFA) of Renal Cell Carcinoma. ACG Case Rep J. 2014 Jan 10;1(2):93-5.
3. Weizer AZ, Raj GV, Polascik TJ, et al. Complications after percutaneous radiofrequency ablation of renal tumors. Urology. 2005 Dec;66(6):1176-80.
4. Douglas S, Ogles M, Vick K, Pound CR. Delayed renocolic fistula formation following percutaneous radiofrequency ablation of renal mass: case report and review of the published cases. BJU International; 10.21.2012. https://www.bjuinternational.com/case-studies/delayed-renocolic-fistula-formation-following-percutaneous-radiofreqency-ablation-of-renal-mass-case-report-and-review-of-the-published-cases/ [Accessed 11.10.2019].
5. Mourmouris P, Mperdempes M, Papachristou C, Skolarikos A, et al. Renocolic fistula following radiofrequency ablation of a renal tumor. A rare case report and review of the literature. Hellenic Urology. 2018;30 (2):44-46.
6. Park S, Cadeddu JA. Outcomes of Radiofrequency Ablation for Kidney Cancer. Cancer Control. 2007; 205–210.
7. Allaf ME, Varkarakis IM, Bhayani SB, et al. Pain control requirements for percutaneous ablation of renal tumors: cryoablation versus radiofrequency ablation: initial observations. Radiology. 2005;237:366-370.
8. Park SH, Anderson JK, Matsumoto ED, et al. Radiofrequency ablation of renal tumors: intermediate-term results. J Endourol. 2006;20:569-573.
9. Arzola J, Baughman SM, Hernandez J, et al. Computed tomographyguided, resistance-based, percutaneous radiofrequency ablation of renal malignancies under conscious sedation at two years of follow-up. Urology. 2006;68:983-987.
10. Hegarty NJ, Gill IS, Desai MM, et al. Probe-ablative nephron-sparing surgery: cryoablation versus radiofrequency ablation. Urology. 2006;68 (1 Suppl):7-13.
11. Roach H, Whittlestone T, Callaway MP. Life-threatening hematuria requiring transcatheter embolization following radiofrequency ablation of renal cell carcinoma. Cardiovasc Intervent Radiol. 2006;29:672-674.
12. Park SH, Yoon SK, Sung GT, et al. Radiofrequency ablation treatment for renal cell carcinoma: Early clinical experience. Korean J Radiol 2008; 9:340-47.
13. Gervais D, Arellano R, Mueller P. Percutaneous radiofrequency ablation of renal cell carcinoma. Eur Radiol 2005; 15: 960-67.
14. Rhim H, Dodd G 3rd, Chintapalli K, Wood B, Dupuy D, Hvizda J, Sewell P, Goldberg S. Radiofrequency thermal ablation of abdominal tumors: lessons learned from complications. Radiographics 2004; 24:41-52.
15. Gervais DA, Arellano RS, McGovern FJ, McDougal WS, Mueller PR. Radiofrequency ablation of renal cell carcinoma. II. Lessons learned with ablation of 100 tumors. AJR Am J Roentgenol 2005;185(1):72–80.
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