# Radical Nephrectomy Following Prior Cryoablation for Renal Cell Carcinoma: A Case Report and Literature Review

## TL;DR

A patient with kidney cancer recurrence after cryoablation required radical nephrectomy due to tumor progression into the renal pelvis.

## Contribution

Highlights the rare progression of renal cell carcinoma into the renal pelvis after cryoablation and the need for radical nephrectomy.

## Key findings

- Local recurrence after cryoablation can progress to involve the renal pelvis.
- Radical nephrectomy is a viable treatment option for advanced cases.
- Tailored surgical approaches are essential for optimal outcomes.

## Abstract

Small renal masses account for 48%–66% of renal cell carcinoma diagnoses, influencing management decisions for low‐stage kidney disease. This report presents a case of cancer recurrence and tumor progression into the renal pelvis postcryoablation, managed with radical nephrectomy.

A 70‐year‐old woman with a history of cryoablation for T1b renal cell carcinoma in the right kidney presented with persistent hematuria. Imaging revealed local recurrence and carcinoma invasion of the renal pelvis. The patient underwent open radical nephrectomy. Intraoperatively, the kidney was found adhered to the peritoneum and vena cava. The remaining elements of renal, hilar and adrenal anatomy showed no abnormalities. The postoperative course was uneventful.

While local recurrences following cryoablation can often be safely retreated with cryoablation, progression involving the renal pelvis is rare and demands heightened vigilance and expertise. Tailored approaches, including radical nephrectomy and technical adaptability, are essential for achieving optimal oncological and functional outcomes.