Asymptomatic chyluria presenting with fat-fluid level after renal microwave ablation

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Percutaneous thermal ablation, including microwave ablation, is increasingly used for T1a renal cell carcinoma.
• These minimally invasive techniques offer comparable efficacy to surgery with potentially fewer complications.
• Awareness of potential post-ablation sequelae is crucial for accurate diagnosis and patient management.

Observation:

• A 70-year-old male presented with asymptomatic chyluria.
• The condition was detected incidentally two years following microwave ablation for renal cell carcinoma.
• This represents the first reported case of chyluria after renal microwave ablation therapy.

Findings:

• Chyluria, characterized by the presence of chyle in urine, is a known but uncommon complication of renal procedures.
• While previously reported after partial nephrectomy, it has not been documented following microwave ablation.
• Asymptomatic presentation is common, with diagnosis often occurring serendipitously via imaging detecting a fat-fluid level.

Implications:

• This case expands the spectrum of known complications associated with renal microwave ablation.
• Clinicians should consider chyluria in the differential diagnosis of patients with a history of renal thermal ablation, even years later.
• Further surveillance and understanding of long-term complications of minimally invasive renal tumor treatments are warranted.