Radiological Parameters of Bleeding Renal Angiomyolipoma

Koh, K. B. H.; George, John

doi:10.3109/00365599609182303

Cited by 21 publications

(24 citation statements)

References 7 publications

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“…In a series of 23 patients by Yamakado [6], the largest size was 1.33 cm. The presence of a larger aneurysm is a strong predictor of a potential life-threatening hemorrhage such as the patient presented and is recommended that immediate treatment be instituted once this is seen [7]. Previously, the main predictor for bleeding was the size of the AML with the risk of hemorrhage being significantly greater in AMLs larger than 4 cm [8].…”

Section: Discussionmentioning

confidence: 97%

Large aneurysm in renal angiomyolipoma causing life-threatening retroperitoneal hemorrhage

Magabe

Otele

Mugambi

2014

African Journal of Urology

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Large aneurysms occurring in renal angiomyolipomas (AML) may be encountered. When present, they have a higher propensity to hemorrhage and cause catastrophic intratumoral and perirenal hemorrhages. They also tend to occur more in tuberous sclerosis-associated AML rather than in the sporadic form. A 22-year-old female presented with sudden onset of acute right abdominal pain, hematuria and fainting. At evaluation in the emergency department, the patient was found to be in hemorrhagic shock with hemoglobin of 4 g/dl and low blood pressure of 60/40 mmHg. Fullness and tenderness of the right abdominal flank was also noted. Contrast enhanced CT scan of the abdomen showed a large fatty mass of the right kidney with a surrounding perirenal hematoma. A 4.0 cm wide focus of contrast was seen within the mass highly suspicious of an aneurysm. A subsequent DSA angiogram of the right kidney confirmed the presence of the aneurysm within the mass as the cause of the hemorrhage. The patient underwent successful emergency coil and particle embolization of the aneurysm and mass with control of the bleeding. The patient was diagnosed with tuberous sclerosis syndrome with further clinical findings of cutaneous adenoma sebaceum and lung cystic changes.A 22-year-old female presented to the emergency department with sudden onset of acute right abdominal pain associated with hematuria and fainting. At initial evaluation, the patient was found to be pale with a hemoglobin reading of 4 g/dl and a low blood pressure of 60/40 mmhg. There was also fullness and tenderness of the right abdominal flank. Emergency resuscitation for hemorrhagic shock

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Section: Discussionmentioning

confidence: 97%

Large aneurysm in renal angiomyolipoma causing life-threatening retroperitoneal hemorrhage

Magabe

Otele

Mugambi

2014

African Journal of Urology

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“…AML greater than 4cm in diameter is reported to have a greater propensity for being symptomatic [3]. The main complication of AML is spontaneous haemorrhage, which is considered to be related to the size of the lesion [3,4]. Lesions more than 4 cm are not only likely to be symptomatic but also are liable to spontaneous haemorrhage [3].…”

Section: Discussionmentioning

confidence: 97%

“…Renal AML has female predominance with a sex ratio of female to male 3:1 or 4:1. Renal AML is mostly asymptomatic and often detected incidentally on routine radiological investigations for other complaints [4,5]. The size of the AML is considered to be important in whether the lesion grows or remains about the same in size.…”

Section: Discussionmentioning

confidence: 99%

Increasing Severity of Haematuria with Successive Pregnancies in a Woman with Renal Angiomyolipoma

et al. 2006

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“…An enhanced CT scan showed augmented images of some parts of the tumor; the high-density area visible in the unenhanced CT image did not show significant enhancement on the enhanced CT image. The diagnosis of rupture was based on findings of the CT scan [4][5][6] , on the symptoms, such as abdominal or back pain, and on the laboratory findings, such as a 30% decrease in hematocrit.…”

Section: Methodsmentioning

confidence: 99%

Clinical efficacy of super-selective renal artery embolization for rupture of renal angiomyolipoma

Duan

Zhou

Gao

et al. 2011

Clin. Oncol. Cancer Res.

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OBJECTIVETo evaluate the efficacy of selective transcatheter arterial embolization (TAE) in renal angiomyolipoma (AML) spontaneous ruptures with hemorrhage. METHODS A retrospective evaluation was carried out in 21 renal AML cases with acute bleeding confirmed by imaging. Selective renal arterial embolization was used to control bleeding. All the cases were detected by renal arteriography had abnormal vascular hyperplasia and enlarged blood vessels. RESULTSInitial renal arteriography for all the patients showed that tortuous, hypervascular, and aneurysm-forming angiogenic components with aneurysm formation occurred in 13 cases (61.9%) and extravasation of the contrast agent was found in 8 cases (38.1%). Immediate complete obliteration was technically successful in 19 (90.5%) of the 21 patients. To prevent uncontrollable complications, 3 patients received nephron-sparing surgery after hemodynamic status was stabilized with TAE a week later. Two days and 3 days after the embolizations, 2 patients presented with incomplete embolizations and then underwent nephrectomy when they were in a stable condition. There were no significant differences in the plasma creatinine levels before and after the treatment. All the patients were followed up for 6 months to 6 years (median, 45 months). The largest tumor diameter was reduced from (11.57¡4.28) cm to (9.57¡2.28) cm. The tumor had no blood supply and no relapses have occurred. CONCLUSIONTAE is a technically feasible and minimally invasive procedure for ruptured renal angiomyolipoma. The aneurysms were a predictor of renal AML spontaneous rupture and detection of such aneurysms by CT may help to determine the timing of embolization. In patients who still need surgical treatment, TAE can make tumor resection easier to perform and reduce blood loss during the operation.

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Radiological Parameters of Bleeding Renal Angiomyolipoma

Cited by 21 publications

References 7 publications

Large aneurysm in renal angiomyolipoma causing life-threatening retroperitoneal hemorrhage

Large aneurysm in renal angiomyolipoma causing life-threatening retroperitoneal hemorrhage

Increasing Severity of Haematuria with Successive Pregnancies in a Woman with Renal Angiomyolipoma

Clinical efficacy of super-selective renal artery embolization for rupture of renal angiomyolipoma

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