Combination embolization and radiofrequency ablation therapy for renal cell carcinoma in the setting of coexisting arterial disease

The present report describes two cases of T1b (>4 cm) renal cell carcinoma (RCC) treated with superselective embolization and radiofrequency ablation in the setting of renal artery stenosis and abdominal aortic aneurysm, respectively. In the first case, a solitary functioning kidney was treated with stent placement immediately before RCC embolization. In the second case, a brachial artery approach was used for RCC embolization after a failed femoral approach secondary to an abdominal aortic aneurysm. These cases illustrate the utility of combination therapy for T1b RCC and emphasize the need for interventional radiologists and interventional oncologists to possess the requisite endovascular skills to manage anatomic challenges from coexisting arterial disease when performing image-guided tumor interventions.