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Figure 2d. Exophytic mass in the left kidney. The mass was solid at CT and US; however, biopsy performed at the time of RF ablation was nondiagnostic. No evidence of residual or recurrent tumor was seen after RF ablation. (a) Unenhanced CT scan obtained immediately prior to ablation shows an exophytic left renal mass (arrow). RF ablation of the mass was performed under CT guidance with the patient prone. (b) CT scan obtained during ablation shows minimal perinephric hemorrhage (arrows) and adjacent soft-tissue stranding. (c–e) Contrast-enhanced excretory phase CT scans obtained 1 month (c), 12 months (d), and 49 months (e) after RF ablation show evolution of the ablated lesion with a persistent soft-tissue-attenuation component (arrows in e). A linear circumferential area of high attenuation (arrowheads in e) is seen surrounding the lesion. Analysis of the attenuation of this soft-tissue-attenuation component on both unenhanced CT scans and arterial phase and excretory phase CT scans showed no evidence of tumoral contrast enhancement.
