Wertigkeit der Angiographie in der Beurteilung der Gutartigkeit von Nierentumoren

Abstract

The authors review the literature regarding the angiography of three benign renal tumours: adenoma, angiomyolipoma and angioma. Renal adenomas area rare. Oncocytomas can be classified with papillary adenomas; they are fairly characteristic and can be diagnosed pre-operatively. The tubular, and particularly alveolar form cannot be distinguished angiographically from a carcinoma. Angiomyolipomas (hamartomas) occur in tuberous sclerosis or may be found alone. Angiography can first of all be an aid to topographic classification. Its isolated occurrence may cause difficulties in differentiation from a carcinoma. Certain angiographic signs may enable pre-operative diagnosis: the demonstration of aneurysmal arterial changes, linear course of tumour veins and the frequency of a peri-renal haematoma. Angiolipoma is the renal tumour which is most frequently complicated by pre-renal bleeding. Capillary, plexiform or cavernous angiomas are rare. If the first two are large enough (2 cm), their homogenous hypervascularisation may permit preoperative diagnosis. The diagnosis of cavernous angiomas is more difficult.