Retroperitoneal extrarenal angiomyolipoma at the surgical bed 8 years after a renal angiomyolipoma nephrectomy: A case report and review of literature

Abstract

Retroperitoneal extrarenal angiomyolipoma (RERAML) are rare and close mimickers of retroperitoneal liposarcoma on both imaging and histopathology. However, imaging findings including heterogeneity, hyperdensity on unenhanced computed tomography, intralesional hemorrhage, absence of calcifications, low signal intensity on T2-weighted magnetic resonance imaging, and dilated intratumoral vessels can lead to the diagnosis of RERAML. Diagnosis of RERAML can avoid unnecessary surgery since conservative medical management with continued surveillance has been proven to be effective for RERAML whereas surgical resection is the treatment for liposarcoma. Imaging and laboratory follow-up for at least 5 years has been recommended in patients who underwent surgical resection of angiomyolipoma (AML). We present a case of RERAML in an asymptomatic patient whose AML recurred in the surgical bed 8 years after an ipsilateral nephrectomy for renal AML.

Selective Arterial Embolization for Large or Symptomatic Renal Angiomyolipoma: 10 Years of Follow-up

“…3,[25][26][27] Moreover, recurrence of AML after nephronsparing surgery or after simple nephrectomy has been reported in several studies. [28][29][30] As shown herein, the long-term clinical outcomes (clinical events and renal function) of patients with AML after SAE are not compromised, suggesting that SAE may be as good as nephrectomy for first-line treatment in most patients. Tumor size reduction in our cohort was only 27%, however, this tumor is now a different-less symptomatic entity.…”

Qualitative review of treatment for extrarenal angiomyolipomas

“…In the case of Retroperitoneal Extrarenal Angiomyolipomas (RERAML), imaging and histopathology results are similar to those of retroperitoneal liposarcomas. However, specific findings, such as dilated intratumoral vessels and absence of calcifications, can lead to proper diagnosis and thus, proper, noninvasive treatment and surveillance [8]. As of 2018, only 60 cases of extrarenal angiomyolipomas had been reported, the majority of which were found in the liver or the retroperitoneum [9].…”

An asymptomatic giant extra-renal retroperitoneal angiomyolipoma: Case report

“…The retroperitoneal space is considered one of the rarest places where extra-renal AML can appear. [ 5 ] The tumor manifestations in this place vary according to its size, as it can give compressive symptoms such as obstruction of the ureter and hydronephrosis if it reaches a large size, in addition to digestive symptoms such as nausea, vomiting, constipation, and abdominal pain. AML has many differential diagnoses, the most important of which are liposarcomas, lipomas, leiomyosarcomas, leiomyomas, lymphomas, adenocarcinoma metastasis, and germ cell tumors.…”