Thermal ablation techniques for renal tumours have become the norm in surgically at-risk patients. These percutaneous treatments are locally effective, particularly for tumours measuring less than 4cm. Larger tumours may be treated by adapting the technique and strategy. Multidisciplinary discussion is essential before any decision, in order to decide on the most appropriate technique. Radiofrequency is simple, effective and inexpensive. Cryotherapy is more complex and should be preferred when the tumour is large or there is vascular or urinary tract contact. Microwaves can be used to treat larger tumours. Morbidity is low, but good knowledge of these techniques and of dissection is required to avoid injury to neighbouring digestive or urinary structures.
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