CAScination Cases - Blog

CAScination Cases presents cases performed with CAScination's stereotactic navigation systems. They support diagnosis, treatment and palliative therapy of cancer. CAS-One navigation systems enable the precise localization, puncture and ablation of tumors in liver, kidney and lung. All CAScination Cases are designed in user-friendly way: After the presentation of the treating experts and their institution, age, sex and initial condition of the patient are described. The following section outlines the treatment, followed by a final evaluation. Scans and images illustrate the different stages of planning and intervention and give a more vivid impression of the challenges and benefits of the chosen treatment.

    Navigated kidney ablation

    Navigated ablation of metastatic, light cell, renal carcinoma

    Name: Dr. med. Levent Kara (EBIR)

    Institution: Stadtspital Triemli, Zürich, Switzerland

    Patient age and sex: 50 years, female

    Initial condition:

    • Metastatic light cell renal cell carcinoma, initial on the right kidney pT2a, pN0 (0/11), pM1, Fuhrman grade III (ED 09/13)
    • Status after laparoscopic tumor phrectomy right 10/13
    • Status after total pancreatectomy and en bloc splenectomy 11/13 in multiple pancreatic metastases
    • Status after transsternal bilateral metastasectomy of a total of 7 lung metastases, 01/18
    • Currently: CT staging with size progressive left kidney tumor

    Treatment: Microwave ablation of the left kidney tumor under general anesthesia. The aim of the treatment was to remove the tumour while maintaining the functionality of the left kidney so that the patient would not be required to dialyse in the future. In a surgical tumour resection, too much healthy kidney tissue would be removed, which is urgently needed by the patient to avoid dialysis. Therefore, the decision of the tumour board was unanimous in favour of ablation. Thanks to the navigation system, the antenna could be placed centrally in the tumour with high precision and thus post ablation could be avoided.

    Conclusion: Follow up CT September 12, 2018: Complete ablation - In the area of the aforementioned left kidney tumor, no contrast medium absorption, no perfusion in status after thermal ablation


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    Treatment overview 


    Navigierte Nierenablation 01

    1. Axial overview of tumor (pre-ablation)


    Navigierte Nierenablation 02

    2. Coronal plane of the tumor (pre-ablation)


    Navigierte Nierenablation 03

    3. Needle validation with CAS-One Aiming Device


    Navigierte Nierenablation 04

    4. Follow-up CT 8 months after ablation



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