Total nephrectomy with nephron-sparing surgery for a giant bilateral renal angiomyolipoma: A case report

Zhou, Yihong; Tang, Yuxin; Tang, Jin; Deng, Fei; Gan, Yi; Dai, Yingbo

doi:10.3892/ol.2015.3538

Cited by 10 publications

(5 citation statements)

References 20 publications

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“…When the diameter of renal AML becomes >4 cm, particularly for giant tumors with persistent hemorrhage or suspicion of malignancy, partial or a total nephrectomy is the treatment of choice. 13,14 In the present case, total right nephrectomy was performed.…”

Section: Discussionmentioning

confidence: 81%

Giant Renal Angiomyolipoma: A Case Report

Sharaf,

Henari,

Negarat

2022

JBMS

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Renal Angiomyolipoma (AML), moreover known as a renal hamartoma, is a solid tumor with no malignant characteristics. The inheritance pattern of renal AML is autosomal dominant. If the lesion grows to a large size, a series of clinical manifestations and important complications might also occur. This research paper presents a case of huge renal AML in a 47-year-old lady, who visited the Emergency Department of Bahrain Defence Forces Hospital with right-sided abdominal pain of sudden onset. The patient underwent a total right nephrectomy. The resected mass was sized 10.5 x 13 x 14 cm. Postoperative histopathological examination confirmed the lesion as a huge renal AML. Due to the huge size of the tumor, it is crucial to record similar cases, along with their diagnosis and treatment. Keywords: Abdominal pain, Angiomyolipoma, Hamartoma, Kidney Neoplasms, Nephrectomy

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Section: Discussionmentioning

confidence: 81%

Giant Renal Angiomyolipoma: A Case Report

Sharaf,

Henari,

Negarat

2022

JBMS

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“…Considering the large volume and deep location of the present mass, a robot-assisted LPN was planned to achieve complete removal of the tumor and adequate preservation of renal function. In terms of the surgical approaches for giant renal AMLs, the TP approach is more common as it provides a larger working space, better orientation and wider angles to reach tumors[ 10 , 12 , 13 ]. However, potential complications of the TP approach relate to the bowels caused by bowel mobilization which would prolong recovery time[ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Successful robot-assisted partial nephrectomy for giant renal hilum angiomyolipoma through the retroperitoneal approach: A case report

Luo¹,

Zeng²,

Chen³

et al. 2022

WJCC

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BACKGROUND Giant renal angiomyolipomas (AMLs) may lead to complications including flank pain, hematuria, hypertension, retroperitoneal hemorrhage and even death. Giant AMLs which grow around renal hilar vessels and the ureter are rare. Most previous reports on the treatment of giant renal AMLs have focused on open surgery or a transperitoneal approach, with few studies on the retroperitoneal approach for large AMLs. We here report a case of giant renal hilum AML successfully treated with robot-assisted laparoscopic nephron sparing surgery the retroperitoneal approach, with a one-year follow-up. CASE SUMMARY A 34-year-old female patient was diagnosed with renal AML 11 years ago and showed no discomfort. The tumor gradually increased in size to a giant AML over the years, which measured 63 mm × 47 mm ×90 mm and was wrapped around the right hilum. Therefore, a robotic laparoscopic partial nephrectomy (LPN) via the retroperitoneal approach was performed. The patient had no serious postoperative complications and was discharged soon after the operation. At the one-year follow-up, the patient's right kidney had recovered well. CONCLUSION Despite insufficient operating space via the retroperitoneal approach, LPN for giant central renal AMLs can be completed using a well-designed procedure with the assistance of a robotic system.

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“…Currently, only a scarcity of studies documented the treatment outcomes in giant RAMLs (7)(8)(9). Giant ones are generally given individualized therapeutic algorithm like PN, RN, SAE, and ablation (1).…”

Section: Discussionmentioning

confidence: 99%

“…This is likely to be worse particularly in developing countries. Partial nephrectomy (PN) is a highly recommended treatment, but radical nephrectomy (RN) appears to be mostly applied due to operating difficulty and definitive outcomes (e.g., less perioperative complications, complete removal a suspected malignant tumor) (7)(8)(9). Therefore, how to facilitate PN procedure for these giant ones is worth to explore.…”

Section: Introductionmentioning

confidence: 99%

Deep Learning Plus Three-Dimensional Printing in the Management of Giant (>15 cm) Sporadic Renal Angiomyolipoma: An Initial Report

et al. 2021

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ObjectiveTo evaluate the feasibility and effectivity of deep learning (DL) plus three-dimensional (3D) printing in the management of giant sporadic renal angiomyolipoma (RAML).MethodsThe medical records of patients with giant (>15 cm) RAML were retrospectively reviewed from January 2011 to December 2020. 3D visualized and printed kidney models were performed by DL algorithms and 3D printing technology, respectively. Patient demographics and intra- and postoperative outcomes were compared between those with 3D-assisted surgery (3D group) or routine ones (control group).ResultsAmong 372 sporadic RAML patients, 31 with giant ones were eligible for analysis. The median age was 40.6 (18–70) years old, and the median tumor size was 18.2 (15–28) cm. Seventeen of 31 (54.8%) had a surgical kidney removal. Overall, 11 underwent 3D-assisted surgeries and 20 underwent routine ones. A significant higher success rate of partial nephrectomy (PN) was noted in the 3D group (72.7% vs. 30.0%). Patients in the 3D group presented a lower reduction in renal function but experienced a longer operation time, a greater estimated blood loss, and a higher postoperative morbidity. Subgroup analysis was conducted between patients undergoing PN with or without 3D assistance. Despite no significant difference, patients with 3D-assisted PN had a slightly larger tumor size and higher nephrectomy score, possibly contributing to a relatively higher rate of complications. However, 3D-assisted PN lead to a shorter warm ischemia time and a lower renal function loss without significant difference. Another subgroup analysis between patients under 3D-assisted PN or 3D-assisted RN showed no statistically significant difference. However, the nearness of tumor to the second branch of renal artery was relatively shorter in 3D-assisted PN subgroup than that in 3D-assisted RN subgroup, and the difference between them was close to significant.Conclusions3D visualized and printed kidney models appear to be additional tools to assist operational management and avoid a high rate of kidney removal for giant sporadic RAMLs.

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Total nephrectomy with nephron-sparing surgery for a giant bilateral renal angiomyolipoma: A case report

Cited by 10 publications

References 20 publications

Giant Renal Angiomyolipoma: A Case Report

Giant Renal Angiomyolipoma: A Case Report

Successful robot-assisted partial nephrectomy for giant renal hilum angiomyolipoma through the retroperitoneal approach: A case report

Deep Learning Plus Three-Dimensional Printing in the Management of Giant (>15 cm) Sporadic Renal Angiomyolipoma: An Initial Report

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