Changing Trends in Presentation, Diagnosis and Management of Renal Angiomyolipoma: Comparison of Sporadic and Tuberous Sclerosis Complex-associated Forms

Seyam, Raouf; Bissada, Nabil K.; Kattan, Said; Mokhtar, Ahmed; Aslam, Muhammad; Fahmy, Wahib E.; Mourad, Walid A.; Binmahfouz, Ali A.; Alzahrani, Hassan M.; Hanash, Kamal A.

doi:10.1016/j.urology.2008.07.049

Cited by 151 publications

(131 citation statements)

References 29 publications

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“…On US, AMLs almost always appear as a hyperechoic mass due to the fat component of the tumor, an area of negative attenuation value (<−20 HU), and high signal intensity on T1-weighted on CT MR images. However, not all AMLs demonstrate these classic imaging findings; RCC also appears hyperechoic on US in approximately one third of the cases [1][2][3]8]. Histopathological examinations should be performed in case of suspicious lesions [2].…”

Section: Discussionmentioning

confidence: 99%

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Selective Arterial Embolization of Giant Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex Using Particular and Liquid Embolic Agents

Kocakgol

Cayli²,

Oguz

et al. 2018

Eurasian J Med

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Renal angiomyolipoma (AML) is a benign hamartomatous tumor that is sometimes associated with the tuberous sclerosis complex. We report a 23-year-old man who presented with acute abdominal pain and hematuria. Computed tomography (CT) revealed large heterogeneous right renal mass of 17×13×13-cm diameter, consistent with AML, and acute and subacute hemorrhages. Digital subtraction angiography revealed massive tumor vascularization and multiple aneurysms associated with right renal artery branches. First, polyvinyl alcohol particles were used for the selective embolization of AML. Then, N-butyl cyanoacrylate (glue) mixed with lipiodol in a 1:3 ratio was injected for the permanent embolization of AML. CT scan revealed 59% reduction in size at 5 months after embolization. This case illustrates the selective embolization of giant renal AML with the combination of particular and liquid embolic agents with a significant reduction in size during the follow-up period.

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Section: Discussionmentioning

confidence: 99%

“…Surgery allows the complete resection of the tumor and pathologic confirmation. Surgery can be quite difficult in cases with a complex vascular anatomy, hilar location, or multiplicity of lesions [8].…”

Section: Discussionmentioning

confidence: 99%

Selective Arterial Embolization of Giant Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex Using Particular and Liquid Embolic Agents

Kocakgol

Cayli²,

Oguz

et al. 2018

Eurasian J Med

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“…These tumors are usually divided into two types, namely in the context of TSC or as sporadic; the case discussed herein belongs to the latter category. It was previously reported that renal AML may grow BY 4 cm each year in its maximum dimension (1,2). When the diameter of renal AML reaches >10 cm, the tumor is referred to as 'giant'.…”

Section: Discussionmentioning

confidence: 99%

“…AML is also referred to as renal hamartoma. Previous studies reported that renal AML may grow by 4 cm each year in its maximum dimension (1,2). When renal AMLs grow to a size of >10 cm, they are referred to as 'giant' AMLs.…”

Section: Introductionmentioning

confidence: 99%

Giant renal angiomyolipoma: A case report

Chen

Jin

et al. 2017

mol clin onc

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Abstract. Renal angiomyolipoma (AML), also referred to as renal hamartoma, is a rare solid tumor without malignant characteristics. The inheritance pattern of renal AML is autosomal dominant. If the lesion grows to a large size, a series of clinical manifestations and serious complications may occur. We herein present a case of giant renal AML in a 34-year-old female patient, who presented with left-sided abdominal bloating for ~6 months. Following abdominal ultrasound and computed tomography examination, the patient underwent total left nephrectomy. The resected mass was sized 29x20x10 cm. Postoperative histopathological examination confirmed the lesion as a giant renal AML. There are only few cases of giant renal AML (>20 cm) reported in the literature to date. Due to the large size of the tumor, it is crucial to report similar cases, their diagnosis and treatment.

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“…In past series, surgery has been more prevalent, 1,20,21 although there is a trend towards using more angioembolization at our centre and at other centres around the world. 20 This trend most likely reflects improved angiography techniques and the desire to maintain maximal renal function. No study clearly demonstrates the superiority of one embolic agent.…”

Section: Discussionmentioning

confidence: 99%

Treatment of angiomyolipoma at a tertiary care centre: the decision between surgery and angioembolization

Faddegon

2013

CUAJ

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E138Cite as: Can Urol Assoc J 2011;5(6):E138-E141; http://dx.doi.org/10.5489/cuaj.10028. Epub 2011 Jan 13. AbstractBackground: Angiomyolipoma (AML) is a benign renal neoplasm. First-line therapy includes renal preserving surgery or angioembolization (RAE), both with good outcomes in isolated studies. However, there are no comparative randomized trials and no clinical guidelines to help clinicians decide between these treatment modalities. Our study examines the patterns of AML treatment at a tertiary care centre to evaluate how local urologists have been treating this disease. Methods: This is a retrospective study of all AMLs treated at the Vancouver General Hospital (Vancouver, BC, Canada) over the past 10 years with either RAE or surgical excision. Searches were performed of the radiology and pathology dictation systems, using the following keywords: AML, angiomyolipoma, angioembolization, embolization, surgery, partial nephrectomy and nephrectomy. Results: At our institution, more AMLs were treated by surgery than angioembolization (42 vs. 17 cases). Angioembolization was more often chosen for cases of multifocal AML (35% vs. 7%) and acute hemorrhage (50% vs. 14%). In the angioembolization cases, particles were the embolic agent of choice (used 40% of the time). Conclusions: Angioembolization allows rapid patient stabilization in cases of acute hemorrhage, and provides good renal preservation in cases of multifocal AML. It may also be preferred in large masses when partial nephrectomy is not feasible. Surgery should be performed in cases of diagnostic uncertainty or complex vascular anatomy not amenable to RAE. Prospective randomized studies are needed to compare RAE and surgery to better define their indications in sporadic AML. RésuméContexte : Un angiomyolipome (AML) est une tumeur bénigne du rein. Le traitement de première intention comprend une chirurgie de conservation rénale ou une angioembolisation rénale, qui ont toutes deux donné de bons résultats dans des études isolées. Cependant, aucun essai comparatif randomisé n'a été mené et il n'existe pas de lignes directrices pour aider les cliniciens à choisir entre ces modalités thérapeutiques. Notre étude a examiné les tendances dans le traitement de l'AML à un centre de soins tertiaires pour évaluer comment les urologues y traitent cette maladie.

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Changing Trends in Presentation, Diagnosis and Management of Renal Angiomyolipoma: Comparison of Sporadic and Tuberous Sclerosis Complex-associated Forms

Cited by 151 publications

References 29 publications

Selective Arterial Embolization of Giant Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex Using Particular and Liquid Embolic Agents

Selective Arterial Embolization of Giant Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex Using Particular and Liquid Embolic Agents

Giant renal angiomyolipoma: A case report

Treatment of angiomyolipoma at a tertiary care centre: the decision between surgery and angioembolization

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