[Renal-pleural fistula after radiofrequency ablation of renal tumor in VHL patient].

Abstract

Radiofrequency is a minimally invasive therapy allowing tumor destruction by applying physical means to the core of the lesion. There is a particular indication for the hereditary already surgically treated renal carcinomas like Von Hippel-Lindau's disease. We present a case of renal-pleural fistula developed after a percutaneous radiofrequency ablation under computed tomography (CT) guidance of a renal tumor in a VHL female patient with a renal cell carcinoma of the upper pole of the left kidney. The kidney manifestations begin at 20-year-old with the appearance of cystic lesion at the lower pole of the left kidney. At 30-year-old, a computed tomography study revealed a solid lesion arising from a cyst. The patient underwent a partial nephrectomy by flank incision. Follow-up studies discovered three solid lesions of the upper pole of the left kidney. The patient undertook a radiofrequency ablation of these lesions. Follow-up control showed a contrast enhancement of one of the three lesions treated. Under this condition another course of RF was performed, complicated by a renal-pleural fistula. A conservative management of this iatrogenic fistula was attempted combining a water restriction and the insertion of a ureteral catheter. Three weeks were necessary until the fistula completely regress.

AI evidence extraction

Main findings

A renal-pleural fistula occurred after a repeat percutaneous CT-guided radiofrequency ablation of renal tumors in a VHL patient. Conservative management (water restriction and ureteral catheter) led to complete regression after three weeks.

Outcomes measured

• Renal-pleural fistula (iatrogenic complication)
• Regression of fistula after conservative management

Limitations

• Single-patient case report
• No quantitative radiofrequency exposure parameters reported (e.g., frequency, power, duration)
• Clinical complication report; not designed to assess broader health effects of EMF exposure

{
    "study_type": "case_report",
    "exposure": {
        "band": null,
        "source": "radiofrequency ablation (medical procedure)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "Female patient with Von Hippel-Lindau (VHL) disease and renal cell carcinoma",
    "sample_size": 1,
    "outcomes": [
        "Renal-pleural fistula (iatrogenic complication)",
        "Regression of fistula after conservative management"
    ],
    "main_findings": "A renal-pleural fistula occurred after a repeat percutaneous CT-guided radiofrequency ablation of renal tumors in a VHL patient. Conservative management (water restriction and ureteral catheter) led to complete regression after three weeks.",
    "effect_direction": "harm",
    "limitations": [
        "Single-patient case report",
        "No quantitative radiofrequency exposure parameters reported (e.g., frequency, power, duration)",
        "Clinical complication report; not designed to assess broader health effects of EMF exposure"
    ],
    "evidence_strength": "very_low",
    "confidence": 0.7399999999999999911182158029987476766109466552734375,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency ablation",
        "renal tumor",
        "renal cell carcinoma",
        "Von Hippel-Lindau",
        "iatrogenic complication",
        "renal-pleural fistula",
        "CT-guided percutaneous procedure"
    ],
    "suggested_hubs": []
}

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