CT-Guided Percutaneous Cryoablation of a Renal Metastasis From Esophageal Adenocarcinoma

Renal involvement in esophageal adenocarcinoma is an uncommon clinical finding. We describe the case of a 74-year-old man with stage IV esophageal adenocarcinoma and prior hepatic, retroperitoneal nodal, and cerebral metastases who developed a new hypermetabolic lesion in the left kidney on Positron Emission Tomography/Computed Tomography (PET/CT). MRI identified a 3.4 cm enhancing mass, and biopsy confirmed poorly differentiated metastatic adenocarcinoma. The lesion was treated with CT-guided cryoablation using a dual freeze-thaw protocol. The patient tolerated the procedure well, and a small upper-pole bleed identified immediately post-procedure was successfully managed with selective coil embolization. He resumed systemic therapy and remained asymptomatic at the four-week follow-up, with a complete metabolic response at the ablation site on the follow-up PET/CT. This case illustrates the feasibility of CT-guided percutaneous cryoablation as a minimally invasive option for local control of renal metastases in patients with esophageal cancer.