Conservative treatment of renal angiomyolipomas in patients with tuberous sclerosis

Hadley, David; Bryant, Linda; Ruckle, Herbert C.

doi:10.5414/cnp65022

Cited by 30 publications

(20 citation statements)

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“…Retrospective reviews have found the procedure to be safe and well tolerated,16 17 though AMLs in the TSC population appear to have a high recurrence rate, requiring repeat intervention 18. Moreover, recent studies, while supporting arterial embolisation as a first line therapy, advocate the role of conservative management for asymptomatic lesions, particularly if they are slow growing 19 20. Medical therapy has previously been unavailable for the treatment of AMLs but mTOR inhibitors potentially pave the way for an alternative to surgical interventions and will hopefully prove a useful management option in the near future,21 particularly in cases such as this, where there are multiple large lesions.…”

Section: Discussionmentioning

confidence: 99%

Renal angiomyolipomas in tuberous sclerosis—rare but potentially life-threatening lesions

Azim¹,

Rajkumar

2012

BMJ Case Reports

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SUMMARYWe discuss an 18-year-old girl, diagnosed with tuberous sclerosis complex and known to have renal angiomyolipomas (AMLs) but having no regular urological follow-up, who presented with left-sided abdominal pain and haematuria on urine dipstick testing at the out-of-hours General Practitioner (GP) service. She was diagnosed as having urinary tract infection/ pyelonephritis and discharged with simple analgesia and antibiotics. Subsequent imaging of her renal tract demonstrated multiple large AMLs with evidence of recent bleeding, which required arterial embolisation. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Renal angiomyolipomas in tuberous sclerosis—rare but potentially life-threatening lesions

Azim¹,

Rajkumar

2012

BMJ Case Reports

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“…Unlike the procedure in malignant lesions, embolization must only target the territory of the tumor. The most frequently used agents are ethanol, with or without Lipiodol®, and inert particles (21, 22). Cyanoacrylate can be used in certain cases.…”

Section: Indicationsmentioning

confidence: 99%

Transcatheter Arterial Embolization in Patients with Kidney Diseases: an Overview of the Technical Aspects and Clinical Indications

et al. 2010

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Therapeutic embolization is defined as the voluntary occlusion of one or several vessels, and this is achieved by inserting material into the lumen to obtain transient or permanent thrombosis in the downstream vascular bed. There are a number of indications for this approach in urological practice, in particular for the patients with parenchymatous or vascular kidney disease. In this review, we present the different embolization techniques and the principally employed occluding agents, and then we present the principal clinical indications and we discuss other pathologies that may benefit from this non-invasive therapy. The complications, side effects and main precautions associated with this approach are also described.

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“…The large size of the mass with predominance of the blood vessels in the present case predisposes to spontaneous hemorrhage which threatened the life of the patient. In previous reports, most of the AMLs are smaller than 4 cm, usually asymptomatic, and very unlikely to bleed [3]. However, 80% to 90% of AMLs equal to or greater than 4 cm in diameter are symptomatic, and 50% to 60% of these result in spontaneous hemorrhage [3].…”

Section: Discussionmentioning

confidence: 94%

“…However, 80% to 90% of AMLs equal to or greater than 4 cm in diameter are symptomatic, and 50% to 60% of these result in spontaneous hemorrhage [3]. The usual symptoms are fl ank pain, palpable mass, nausea, vomiting, hematuria, anemia, hypertension, urinary tract infection, shock, or even kidney failure [3].…”

Section: Discussionmentioning

confidence: 99%

“…Rarely, the absence of fat, involvement of surrounding structures, and invasion of the inferior vena cava may be seen in angiomyolipoma, making it diffi cult to be differentiated from renal cell carcinoma. Other rare fat-containing renal lesions such as lipoma, myolipoma, liposcarcoma, oncocytoma and Wilms tumor may be similar to angiomyolipoma [3].…”

Section: Discussionmentioning

confidence: 99%

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Renal Angiomyolipoma complicated with spontaneous hemorrhage in a 22 years old female, a rare presentation

Aboutaleb¹,

Badreldin²

2011

UIJ

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Renal angiomyolipoma (AML) rarely presents with hemorrhage. We report a case of a large-sized renal angiomyolipoma (12 × 7 × 6.5 cm) with intratumoral and subcapsular spontaneous hemorrhage in a 22-year-old female. The diagnosis was based on radiological features by CT scan and histopathological examination after removal of the tumor. The patient subsequently underwent right nephrectomy. Spontaneous hemorrhage from AML should be expected in large-size tumors and fast decision for intervention is mandatory.

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Conservative treatment of renal angiomyolipomas in patients with tuberous sclerosis

Cited by 30 publications

References 0 publications

Renal angiomyolipomas in tuberous sclerosis—rare but potentially life-threatening lesions

Renal angiomyolipomas in tuberous sclerosis—rare but potentially life-threatening lesions

Transcatheter Arterial Embolization in Patients with Kidney Diseases: an Overview of the Technical Aspects and Clinical Indications

Renal Angiomyolipoma complicated with spontaneous hemorrhage in a 22 years old female, a rare presentation

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