Abstract
Microwave ablation is a minimally invasive alternative to nephrectomy for select patients with renal cell carcinoma (RCC), particularly those with solitary kidneys or significant comorbidities. We present a case of a 55-year-old male with stage 3B chronic kidney disease and biopsy-confirmed clear cell RCC who underwent successful microwave ablation. Post-procedure imaging demonstrated a stable lesion size without recurrence. However, follow-up revealed persistent chyluria, likely as a rare and delayed consequence of ablation. This report discusses the pathophysiology, diagnostic considerations, and clinical implications of chyluria in the post-ablation setting.