322 - Abdominal Wall Pseudohernia After Percutaneous Cryoablation for Renal Cell Carcinoma: A Six-Patient Case Series

Wednesday, April 15, 2026

12:18 PM - 12:27 PM ET

Presenting Author(s)

YS

Yash Suri, MD, MS

Resident
University of Florida, United States

Author/Co-author(s)

CL

Chase Labiste, MD

Resident
University of Florida, United States
ML

Michael Lazarowicz, MD

Assistant Professor, VIR
University of Florida, United States
HD

Hugh C. Davis, MD

Associate Professor, Vascular and Interventional Radiology
Department of Radiology, University of Florida, United States
MD

Melissa Deiter, PA

Physician Assistant
Shands at the University of Florida - - Gainesville, FL, United States
MG

Matthew Grove, MD

Assistant Professor, VIR
University of Florida, United States
BG

Brian Geller, MD

Interventional Radiologist
University of Florida College of Medicine- Shands, United States
SW

Sean Wiley, RPA

Radiology Assistant
Shands at the University of Florida, United States
JZ

Joseph Zachary, MD

Assistant Professor, VIR
University of Florida, United States
DP

Darren Postoak, MD

Assistant Professor, VIR
University of Florida, United States
JV

Jeffrey Vogel, MD

Section Chief VIR
University of Florida, United States

Purpose: To describe the occurrence, risk factors, and clinical outcomes of abdominal wall pseudohernia (AWP) following percutaneous cryoablation (PCA) for renal masses.

Materials and Methods: We retrospectively reviewed six patients who developed AWP after PCA for renal masses. Patient demographics, tumor characteristics, and procedural details were extracted, including cryoprobe trajectory and use of hydro-/pneumo-dissection. AWP was defined as focal abdominal wall bulging in the upright position with loss of reflex contraction and intact fascia. Outcomes were assessed by clinical follow-up.

Results: Six patients (median age 77 years, range 63–82; five males, one female; mean BMI 28.3) developed AWP following PCA. Median tumor size was 2.8 cm (range 1.7–4.0). Tumors were located in the upper pole (n=3), lower pole (n=2), and interpolar region (n=1). All cases involved cryoprobe trajectories traversing the erector spinae muscle. Hydro-/pneumo-dissection was performed in all six patients. The number of cryoprobes ranged from 2–3, with most patients undergoing a single treatment session (n=5). All six patients had prior abdominal surgery. No patients required surgical repair.

Conclusion: AWP is a rare but clinically significant outcome of PCA for renal masses. In this series, all cases were associated with dorsal cryoprobe trajectories through the erector spinae muscle, even when protective dissection was employed. The universal history of prior abdominal surgery may represent an additional susceptibility factor. These findings are consistent with prior reports and parallel other ablation-related hernia syndromes, such as diaphragmatic hernia after percutaneous hepatic tumor thermal ablation. All cases were managed non-operative and resolved within a 6 month time. Although not entirely preventable, pre-treatment planning (including careful probe planning with adjunctive protective techniques) may help reduce risk.