Angiomyolipoma in a Patient with Tuberous Sclerosis

Abstract

Angiomyolipoma (AML) is a benign hamartoma with two distinct clinical settings, one sporadic with no underlying predisposing conditions, and another linked to the tuberous sclerosis complex in which lesions tend to be larger, multifocal and bilateral and more likely to cause spontaneous hemorrhage. Due to the benign nature of the disease the elective treatment of AML, which is conventionally required for neoplasms with diameter greater that 4 centimeters, should have the aim of lowering the risk of bleeding without sacrifice of the normal renal parenchyma and with the minimum of invasiveness. The bleeding from AML, the lack of a pseudocapsule and the collocation of the tumour can be a limit to a correct nephron sparing surgery. For these reasons a selective angiographic embolization, which allows the vascular exclusion and the lowering of the risk of bleeding with reduced invasiveness, is actually indicated to treat AML. A case of successful embolization of AML in a patient with tuberous sclerosis is presented.