Renal Angiomyolipoma - Experience of 20 Years in Taiwan

Giant bleeding renal angiomyolipoma: Diagnosis and management

“…The other presents as an isolated lesion. [10][11][12][13][14][15][16][17] Between 40 and 80% of patients with TS have renal AML which are often asymptomatic, small, bilateral and multifocal and without male or female preponderance. 9,18 In patients without TS, AML are usually larger, solitary, unilateral with a female preponderance and typically occur in the 5th and 6th decades of life.…”

“…21 Our patient presented with the typical symptoms of AML without TS namely loin pain, a mass in the loin and haematuria. 13,16 The pain in such cases is thought to be due to repeated haemorrhages within the tumour. 22 Tumour size correlates well with the presence of symptoms.…”

“…15 Similarly, in another series, 90% (20/22) of patients with lesions larger than 4 cm were symptomatic. 13 In recent years, US and CT have made preoperative diagnosis of renal AML possible in almost all cases. 6,13,17 Radiographic features on plain film and IVU are non-specific and unreliable.…”

“…13 In recent years, US and CT have made preoperative diagnosis of renal AML possible in almost all cases. 6,13,17 Radiographic features on plain film and IVU are non-specific and unreliable. The typical findings on US is a well defined hyperehoic mass, 11,15,19 but this appearance may be altered by a low mature fat content of the tumour, haemorrhage and necrosis.…”

“…In such cases, the tumour may be indistinguishable from other solid tumours. 13,17,20,23 Angiography is no longer used as a primary imaging modality in the diagnosis of AML. It is invasive and is not reliable in differentiating AML from malignant tumours.…”