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Figure 24 (Figure on facing page) Normal findings after cryoablation of renal cell carcinoma.

(A) CT scan before cryoablation shows a small anterior mid-left renal cell carcinoma (arrow).

(B) One month after cryoablation, gadolinium-enhanced Tl-weighted 2-D gradient echo MRI shows no enhancement in the kidney at the cryoablation site. Low-signal intensity perinephric changes (arrows) merge imperceptibly with the ablated renal parenchyma. (C) 4.5 years after ablation, gadolinium-enhanced Tl-weighted 3-D gradient echo MRI shows only cortical loss at the site of tumor ablation (arrow). Abbreviations: CT, computed tomography; MRI, magnetic resonance imaging.

Metastatic disease can occur in regional lymph nodes or in distant sites. Lung, mediastinal, bone, liver, contralateral kidney, adrenal gland, and brain metastases are common, but metastatic disease of the small bowel and peritoneal cavity can also occur (55). In this event, imaging reverts to the role of monitoring treatment for metastatic disease.

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