Colo-renal fistula following percutaneous radiofrequency ablation of a renal tumor. A case report and review of treatment options

Background: Colo-renal fistula formation is a very rare complication following percutaneous radiofrequency ablation (RFA) in the management of renal cell carcinoma. In this paper we describe the management of a patient with a left colo-renal fistula occurring after renal tumor RFA. Additionally, we present a thorough literature review of reported cases of colo-renal fistulae after percutaneous RFA to further highlight their treatment challenges. Summary: Two weeks after undergoing percutaneous RFA of an incidental 3cm left renal mass, a 67-year-old male was re-admitted to the hospital with a symptomatic colo-renal fistula. Patient ultimately failed conservative management with broad spectrum antibiotics and ureteral stent placements, and subsequently underwent segmental colonic resection and renorrhaphy, with complete renal preservation. Conclusion: Although complications after RFA of renal tumors are rare, iatrogenic colo-renal fistula formation is a significant complication requiring a multi-disciplinary approach with a trial of non-operative management prior to surgical intervention.