A Case of Lipiduria After Arterial Embolization for Renal Angiomyolipomas

Abstract

We report the case of a 31-year-old woman who suffered lipiduria after selective transcatheter arterial embolization for renal angiomyolipoma (AML). Computed tomography confirmed cystic liquefactive necrosis with fat-fluid level in AML. Although the process by which AML fat tissue excretion occurs is not clear, we speculated that the infarcted AML was connected to the urinary collection duct system and subsequently its adipose component was excreted into the urine.

Renal colic due to fatty tissue obstruction of the ureter following selective arterial embolisation of a 10 cm angiomyolipoma

“…To the best of our knowledge, such renal colic due to fatty tissue migration into the collecting system has never before been reported. Nonetheless, Ishibashi et al 8 already reported a case of asymptomatic lipiduria following arterial embolisation of an AML.…”

Tratamento endovascular de angiomiolipoma renal por embolização arterial seletiva

“…One vial of 300-500-micron Embosphere® (BioSphere Medical) was used for the embolization of feeding vessels. There is a correlation between RAML size and the appearance of symptoms and complications [1][2][3][4][5][6][7][8][9]14,16 . The most frequent sign, in 85% of the cases, is abdominal or lumbar pain 1,6,7,10,13,16 .…”

“…Angiomyolipomas (AML) are rare benign tumors that account for 2% to 3% of all renal tumors [1][2][3][4][5][6][7] . They are twice more frequent among women 1,5,6,8 . Most are sporadic, but 10% are associated with tuberous sclerosis complex (TSC) [1][2][3][4][5][6][7][9][10][11] .…”

“…AML are hamartomas that contain fat, blood vessels and muscle fibers [1][2][3][4][5][6][7][8][9][10][11][12][13] .…”

“…Selective arterial embolization (SAE), an effective and safe treatment of renal angiomyolipomas (RAML), 1,3,5,6,8,10,13 is used in the prophylaxis of complications of high risk tumors, to contain acute hemorrhages, 1,2,4,6,9,11,14,15 to delay invasion of the renal parenchyma 1,2,[4][5][6]8,10,11 and to reduce bleeding during surgery as a preoperative adjuvant measure 9,14,16 .…”