Renal epithelioid angiomyolipoma: magnetic resonance imaging characteristics

Cong, Xinying; Zhang, Jin; Xu, Xiangdong; Zhang, Miaomiao; Chen, Yan

doi:10.1007/s00261-018-1548-6

Cited by 12 publications

(8 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…meaningful phenomena previously (27), but showed no statistical significance in this study. Wedge-shaped signs and necrotic or cystic lesions showed a significant difference between RAML-wvf and ccRCC, according to Ma et al (28), but they did not show statistical significance in multivariate analysis in this study.…”

Section: Discussioncontrasting

confidence: 88%

A Non-Invasive Scoring System to Differential Diagnosis of Clear Cell Renal Cell Carcinoma (ccRCC) From Renal Angiomyolipoma Without Visible Fat (RAML-wvf) Based on CT Features

Wang

Zhou

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

BackgroundRenal angiomyolipoma without visible fat (RAML-wvf) and clear cell renal cell carcinoma (ccRCC) have many overlapping features on imaging, which poses a challenge to radiologists. This study aimed to create a scoring system to distinguish ccRCC from RAML-wvf using computed tomography imaging.MethodsA total of 202 patients from 2011 to 2019 that were confirmed by pathology with ccRCC (n=123) or RAML (n=79) were retrospectively analyzed by dividing them randomly into a training cohort (n=142) and a validation cohort (n=60). A model was established using logistic regression and weighted to be a scoring system. ROC, AUC, cut-off point, and calibration analyses were performed. The scoring system was divided into three ranges for convenience in clinical evaluations, and the diagnostic probability of ccRCC was calculated.ResultsFour independent risk factors are included in the system: 1) presence of a pseudocapsule, 2) a heterogeneous tumor parenchyma in pre-enhancement scanning, 3) a non-high CT attenuation in pre-enhancement scanning, and 4) a heterogeneous enhancement in CMP. The prediction accuracy had an ROC of 0.978 (95% CI, 0.956–0.999; P=0.011), similar to the primary model (ROC, 0.977; 95% CI, 0.954–1.000; P=0.012). A sensitivity of 91.4% and a specificity of 93.9% were achieved using 4.5 points as the cutoff value. Validation showed a good result (ROC, 0.922; 95% CI, 0.854–0.991, P=0.035). The number of patients with ccRCC in the three ranges (0 to <2 points; 2–4 points; >4 to ≤11 points) significantly increased with increasing scores.ConclusionThis scoring system is convenient for distinguishing between ccRCC and RAML-wvf using four computed tomography features.

show abstract

Section: Discussioncontrasting

confidence: 88%

A Non-Invasive Scoring System to Differential Diagnosis of Clear Cell Renal Cell Carcinoma (ccRCC) From Renal Angiomyolipoma Without Visible Fat (RAML-wvf) Based on CT Features

Wang

Zhou

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…If magnetic resonance imaging shows a gradually increasing T1-weighted signal (acute hemorrhage) and low T2-weighted signal (due to the highly cellular nature of the lesion), obvious edge and heterogeneity enhancement can be observed. 10…”

Section: Discussionmentioning

confidence: 99%

“…9 If magnetic resonance imaging shows a gradually increasing T1-weighted signal (acute hemorrhage) and low T2-weighted signal (due to the highly cellular nature of the lesion), obvious edge and heterogeneity enhancement can be observed. 10 Under hematoxylin-eosin staining, EAML in most cases shows proliferation of and vascular invasion by epithelioid cells accompanied by atypia, mitotic activity, necrosis, and hemorrhage. Eosinophilic granular cytoplasm is often abundant in the visual field, and ganglioid-like cells of epithelioid origin are observed in some areas.…”

Section: Discussionmentioning

confidence: 99%

Clinical challenges and management of primary renal epithelioid angiomyolipoma of duplex kidney with paraneoplastic syndrome

Wang

Wan

et al. 2021

J Int Med Res

View full text Add to dashboard Cite

Giant renal epithelioid angiomyolipoma of a duplex kidney has rarely been reported, especially in patients with paraneoplastic syndrome. The present report describes a 33-year-old man of Miao nationality who presented with a 6-month history of intermittent dull pain in the left upper abdomen that occurred after eating. Ultrasonography, intravenous pyelography, and computed tomography revealed a mass lesion localized in the left kidney and connected to the left renal artery. Radical nephrectomy was successfully performed, and the postoperative histopathological examination verified the lesion as epithelioid angiomyolipoma. Inpatient treatment for paraneoplastic syndrome was also performed. The present case is discussed in the context of the patient’s clinical presentation and imaging findings, drawing attention to the challenges and management of this condition to assist clinicians in practice.

show abstract

“…Cong et al . reported that the presence of hypointensity on T2 weighted image, restricted diffusion on diffusion‐weighted image, round tumor‐kidney interface, reticular, and marked enhancement (rapid wash‐in and wash‐out) should further raise suspicion for renal EAML on MRI …”

Section: Discussionmentioning

confidence: 99%

“…reported that the presence of hypointensity on T2 weighted image, restricted diffusion on diffusion-weighted image, round tumor-kidney interface, reticular, and marked enhancement (rapid wash-in and wash-out) should further raise suspicion for renal EAML on MRI. 6 EXIST-2 is a randomized, double-blind, phase 3 trial that showed a significant reduction in AML volume compared with a placebo in TSC patients. 7 To our best knowledge, there are only five reported cases of malignant EAML treated with everolimus.…”

Section: Discussionmentioning

confidence: 99%

Metastatic epithelioid angiomyolipoma treated with everolimus in a patient receiving hemodialysis: A case report

et al. 2019

View full text Add to dashboard Cite

Introduction A patient undergoing hemodialysis and being treated with everolimus for metastatic epithelioid angiomyolipoma has never been described in the literature, to our knowledge. Case presentation A 53‐year‐old woman who had undergone trans‐arterial embolization for epithelioid angiomyolipoma was referred with a chief complaint about right knee pain. Hemodialysis had been started after the embolization. Needle biopsy specimens of tumors obtained from behind the right kidney and in the right femur were diagnosed as epithelioid angiomyolipoma metastases. The patient underwent treatment with everolimus and achieved a partial response after 6 months of treatment without serious adverse events. Conclusion Everolimus might be effective for patients with metastatic epithelioid angiomyolipoma who are undergoing hemodialysis.

show abstract

Renal epithelioid angiomyolipoma: magnetic resonance imaging characteristics

Abstract: The presence of hypointensity on T2WI, restricted diffusion on DWI, round tumor-kidney interface, reticular, and marked enhancement (rapid wash-in and wash-out) should further raise suspicion for renal EAML. The diagnosis may be confirmed by pathological analysis.

Cited by 12 publications

References 31 publications

A Non-Invasive Scoring System to Differential Diagnosis of Clear Cell Renal Cell Carcinoma (ccRCC) From Renal Angiomyolipoma Without Visible Fat (RAML-wvf) Based on CT Features

A Non-Invasive Scoring System to Differential Diagnosis of Clear Cell Renal Cell Carcinoma (ccRCC) From Renal Angiomyolipoma Without Visible Fat (RAML-wvf) Based on CT Features

Clinical challenges and management of primary renal epithelioid angiomyolipoma of duplex kidney with paraneoplastic syndrome

Metastatic epithelioid angiomyolipoma treated with everolimus in a patient receiving hemodialysis: A case report

Contact Info

Product

Resources

About