Computed Tomography and Magnetic Resonance Findings of Fat-Poor Angiomyolipomas

Potretzke, Aaron M.; Potretzke, Theodora A.; Bauman, Tyler M.; Knight, B. Alexander; Park, Alyssa M.; Mobley, Jonathan; Figenshau, R. Sherburne; Siegel, Cary

doi:10.1089/end.2016.0219

Cited by 14 publications

(10 citation statements)

References 31 publications

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“…AML accounted for nearly half of this group of benign masses. This shows that the differentiation between AML and RCC remains difficult in routine practice [202122]. …”

Section: Diagnosismentioning

confidence: 99%

“…Imaging findings that should raise the suspicion of AML include the absence of calcification, the absence of perinephric collateral vessels, multiple lesions, hyperattenuation in comparison to renal parenchyma on UECT, and hypointensity on T2-weighted MRI. However, because these characteristic features are not present in every AML and exceptions do exist, no single finding or modality is perfectly accurate [2021222324]. …”

Section: Diagnosismentioning

confidence: 99%

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Renal Angiomyolipoma: The Good, the Bad, and the Ugly

Vos

Oyen

2018

Journal of the Belgian Society of Radiology

106

126

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Angiomyolipomas (AMLs) are the most common benign renal tumours. Most of these neoplasms are found incidentally on imaging. However, symptomatic presentation does exist.Renal AMLs are typically composed of smooth muscle, blood vessels, and adipose tissue. Because of the abundant fat tissue, they give a characteristic appearance on imaging and are therefore easily diagnosed. However, sometimes they contain too little fat to be detected. This increases the difficulty in differentiating them from renal cell carcinoma (RCC).Management of AML is based on clinical presentation and should be individualized for every patient. Treatment modalities range from active surveillance to more invasive approaches.

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“…AML accounted for nearly half of this group of benign masses. This shows that the differentiation between AML and RCC remains difficult in routine practice [202122]. …”

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Renal Angiomyolipoma: The Good, the Bad, and the Ugly

Vos

Oyen

2018

Journal of the Belgian Society of Radiology

106

126

View full text Add to dashboard Cite

show abstract

“…However, in fpAML, differentiation from renal cell carcinoma is difficult due to the lack of macroscopic fat. The ratio of fpAML with a composition mainly of smooth muscle is high, and this is reflected by their higher attenuation on non-contrast-enhanced CT compared to the renal parenchyma, as well as a uniform contrast enhancement, and a low signal on T2-weighted imaging in MRI [5] [6]. However, differential diagnosis is difficult due to diverse findings depending on the proportion of tissues involved and many findings overlap with renal cell carcinoma [7].…”

Section: Discussionmentioning

confidence: 99%

Fat Poor Renal Angiomyolipoma Showing Collapsed Shape: A Case Report

Fujii¹,

Hasegawa²,

Kajiyama³

et al. 2022

OJRad

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Fat-poor renal angiomyolipoma (fpAML) and renal cell carcinoma (RCC) are difficult to differentiate and misdiagnosis can lead to unnecessary nephrectomy. We experienced a case showing a "collapsed shape" which reflected a fpAML tissue type. A renal tumor was incidentally discovered in a 42-year-old female during an abdominal ultrasound. RCC was suspected according to CT and MRI imaging results, and a partial nephrectomy was performed. However, the pathologic diagnosis was fpAML. Upon reevaluation of preoperative images, morphological change to the tumor due to contact with surrounding tissues: the collapsed shape was observed and could be identified by CT, which is the gold standard test for differentiating renal tumors. In cases where the collapsed shape is observed in a renal tumor, fpAML should be considered.

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“…Imaging modifications and novel image analysis try to demonstrate the presence of a minute amount of fat within the lesion. Such techniques include ultrasound ( 81 ), computed tomography ( 82 , 83 ), and magnetic resonance imaging (MRI) ( 84 – 88 ). Preoperative diagnosis is possible by transcutaneous biopsy.…”

Section: Renal Malignancymentioning

confidence: 99%

The Risks of Renal Angiomyolipoma: Reviewing the Evidence

Seyam

Alkhudair

Kattan

et al. 2017

jkcvhl

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Renal angiomyolipoma (RAML), though a rare benign tumor, may impose a significant morbidity or even mortality due to its unique characteristics and the complications subsequent to its treatment. The classic tumor variant is composed of smooth muscular, vascular, and fatty components. The most straightforward diagnosis is when the fat component is abundant and gives a characteristic appearance on different imaging studies. In fat-poor lesions, however, the diagnosis is difficult and presumed a renal cell carcinoma. Yet, some variants of RAML, though rare, express an aggressive behavior leading to metastasis and mortality. The challenge lies in the early detection of benign variants and identifying aggressive lesions for proper management. Another challenge is when the vascular tissue component predominates and poses a risk of hemorrhage that may extend to the retroperitoneum in a massive life-threatening condition. The predicament here is to identify the characteristics of tumors at risk of bleeding and provide a prophylactic treatment. According to the clinical presentation, different treatment modalities, prophylactic or therapeutic, are available that span the spectrum of observation, embolization, or surgery. Renal impairment may result from extensive tumor burden or as a complication of the management itself. Improvement of diagnostic techniques, super-selective embolization, nephron-sparing surgery, and late treatment with the mammalian target of rapamycin inhibitors have provided more effective and safe management strategies. In this review, we examine the evidence pertaining to the risks imposed by RAML to the patients and identify merits and hazards associated with different treatment modalities.

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Computed Tomography and Magnetic Resonance Findings of Fat-Poor Angiomyolipomas

Cited by 14 publications

References 31 publications

Renal Angiomyolipoma: The Good, the Bad, and the Ugly

Renal Angiomyolipoma: The Good, the Bad, and the Ugly

Fat Poor Renal Angiomyolipoma Showing Collapsed Shape: A Case Report

The Risks of Renal Angiomyolipoma: Reviewing the Evidence

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