Radio-frequency Ablation of Solitary Adrenal Gland Metastasis From Renal Cell Carcinoma

OBJECTIVES To evaluate the early clinical experience associated with radio-frequency (RF) ablation in patients with solitary adrenal gland metastasis of renal cell carcinoma (RCC). METHODS A total of 5 patients were treated with RF ablation of adrenal gland metastasis from RCC under computed tomography (CT) guidance between 2006 and 2007. Radiotherapeutics generator (Boston Scientific, Natick, MA) and Radiotherapeutics RF ablation probe with "umbrella" array tip (Boston Scientific, Natick, MA) were used. These patients were contraindicated for surgery due to several associated morbidities. All patients underwent a tumor biopsy before RF. The access was percutaneous in all patients. Tumor control was defined as the absence of contrast enhancement in the tumor on CT. Data were collected in a retrospective manner. RESULTS Five patients were treated with a RF ablation of the adrenal metastasis. The average age of the patients was 69.4 +/- 11.1 years (57-87), the average time between the radical nephrectomy and the onset of adrenal metastasis was 5.2 +/- 1.3 years (4-7), and average diameter of the tumor was 3.9 +/- 1.4 cm (2-6). A year after RF, four patients had a total necrosis of their tumor on CT and 1 had an active tumor for which the patient received a second course of RF. An abscess of the adrenal gland had occurred in 1 case requiring a percutaneous drainage. CONCLUSIONS The treatment of metastatic adrenal gland with RF broadens the range of treatment of metastatic RCC. The efficacy of this therapeutic modality must be confirmed by larger series with the longest follow-up. UROLOGY 74: 1341-1343, 2009. (C) 2009 Elsevier Inc.