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

We present a case of asymptomatic chyluria in a 70-year-old man detected two years after microwave ablation of renal cell carcinoma. Chyluria is a rare complication of partial nephrectomy, but has not been previously reported after renal microwave ablation therapy. Recently, percutaneous thermal ablation techniques for T1a renal cancers are in surge due to comparable treatment efficacy, less invasive nature and lower complications. It is imperative to be aware of the post-ablation imaging findings and complications for correct diagnosis. Most patients with chyluria are clinically asymptomatic; therefore, serendipitous diagnosis on imaging detecting fat-fluid level may not be unusual.