Introduction: Cryoablation is an established nephron-sparing option for small renal masses, particularly in patients unsuitable for surgery. However, definitive histopathological assessment post-ablation is limited due to the in situ nature of treatment. This report details a case of delayed partial nephrectomy after cryoablation, enabling comprehensive histopathological evaluation of long-term treatment effects. Case presentation: A 50-year-old man with uncontrolled hypertension, diabetes, and triple-vessel coronary disease presented with a 2.5 cm right renal mass. Cardiovascular instability deferred initial surgery. Following coronary intervention requiring anticoagulation, percutaneous cryoablation was performed using CT-guided 3D reconstruction for precise probe placement and ice-ball confirmation. After 388 days, laparoscopic partial nephrectomy was performed. Histopathology revealed a 1.9 cm clear cell renal cell carcinoma. Approximately one-third of tissue showed post-cryoablation changes. Three distinct zones were identified: viable carcinoma, coagulative necrosis with preserved glomerular outlines, and viable parenchyma. Serial follow-up over 2 years showed transient creatinine elevation normalizing by 3 months, with no recurrence or metastasis. Conclusions: This case provides rare whole-lesion histopathological assessment after renal cryoablation, illustrating heterogeneous long-term tissue response and supporting cryoablation as a disease-control or bridging strategy in medically high-risk patients.
Journal of clinical medicine. 2026 Jun 10*** epublish ***
Alimire Maimaitijiang, Yaohui Wang, Zhaopei Liu, Qingzhi Xiang, Hui Zhu, Xuejun Zhang, Hualei Gan, Yu Zhu
Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China., Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.