Spontaneous rupture of renal angiomyolipoma during pregnancy

Li, Ao; Ogasahara, Eriko; Okuda, Yasuhiko; Hirata, Shuji

doi:10.1136/bcr-2016-217284

Cited by 10 publications

(11 citation statements)

References 9 publications

(2 reference statements)

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“…We also find some pregnant women who are diagnosed with renal angiomyolipoma are treated with conservative follow-up. A case was reported that a pregnant woman with a 10 cm mass suggestive of angiomyolipoma in the left kidney had a spontaneous rupture at the 20th week of her pregnancy, and the operation was performed until the 34th week [ 14 ]. It was reported that almost 75% of renal angiomyolipoma pregnant women had a risk of tumor rupture [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Management of renal tumors during pregnancy: case reports

Zhao

Yang

et al. 2021

BMC Nephrol

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Background Renal tumors during pregnancy are rare and the treatment requires evaluation of both the patient and the fetus. No consensus or guidelines has been proposed or verified in this field. We successfully managed three renal tumor cases during pregnancy and reviewed the relative literature. Case presentation In the first renal cell carcinoma case diagnosed in the 21st week of pregnancy, laparoscopic retroperitoneoscopic partial nephrectomy was performed in the 26th week of pregnancy. In the second renal cell carcinoma case diagnosed in the 3rd week of pregnancy, laparoscopic retroperitoneoscopic radical nephrectomy was carried out after the abortion. In the third angiomyolipoma case who was diagnosed before pregnancy but received no treatment, we performed laparoscopic retroperitoneoscopic partial nephrectomy during the 17th week of pregnancy due to the rapid enlargement of the tumor. Conclusion Although no consensus or guidelines for the management of renal tumors in pregnant patients has been proposed or verified, the general rules of kidney tumor management in non-pregnant patients and the guidelines for surgery in pregnancy could be referred to. Renal tumors found in pregnant patients require an individualized treatment regimen involving surgical timing, routes, techniques, and excision ranges, which should be decided by both the patients and the surgical teams.

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Section: Discussionmentioning

confidence: 99%

Management of renal tumors during pregnancy: case reports

Zhao

Yang

et al. 2021

BMC Nephrol

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“…AML during pregnancy is characterized by faster growth, potentially invasive behaviors, and an increased risk of rupture with massive retroperitoneal hemorrhage. [ 24 , 25 ] In particular, spontaneous renal hemorrhage during pregnancy is rare but the consequences may be catastrophic, including maternal shock and intrauterine fetal death. Pregnancy exerts its negative impacts on AML in many ways.…”

Section: Risk Factors For Aml Rupturementioning

confidence: 99%

An update on recent developments in rupture of renal angiomyolipoma

Wang

Peng

et al. 2018

Medicine

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Background:Renal angiomyolipoma (AML) is a common benign tumor of the kidney. The main complication of AML is retroperitoneal hemorrhage caused by AML rupture, which can be severe and life threatening. The risk of AML rupture used to be determined by tumor size. However, these criteria have been challenged by series of clinical studies and case reports, suggesting prediction AML rupture based on tumor size is not always reliable.Methods:The authors searched PubMed using “angiomyolipoma,” “AML,” and “rupture” and reviewed relevant studies. The authors investigated the risk factors of AML rupture using the retrieved literature. The authors also summarized current modalities to evaluate and manage AML.Results:It is established that risk of AML rupture is associated with lesion size. However, genetic abnormality, aneurysm formation, and pregnancy are also risk factors for tumor rupture. Thus, the prediction of AML rupture should be based on a more comprehensive risk assessment system. The management of renal AML and tumor rupture was also discussed in the present paper.Conclusion:The risk of AML rupture is associated with but not exclusive to lesion size. Any decision to intervene AML must be based on multiple factors including risk, symptoms, and auxiliary findings.

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“…Bleeding may prompt emergency treatment. Conservative management and elective caesarian section were reported when the patient was asymptomatic, hemodynamically stable, or could be stabilized by blood transfusions ( 58 – 61 ). Treating a bleeding lesion by nephrectomy or PN may compromise the continuation of pregnancy ( 62 ).…”

Section: Risk Of Bleedingmentioning

confidence: 99%

The Risks of Renal Angiomyolipoma: Reviewing the Evidence

Seyam

Alkhudair

Kattan

et al. 2017

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Renal angiomyolipoma (RAML), though a rare benign tumor, may impose a significant morbidity or even mortality due to its unique characteristics and the complications subsequent to its treatment. The classic tumor variant is composed of smooth muscular, vascular, and fatty components. The most straightforward diagnosis is when the fat component is abundant and gives a characteristic appearance on different imaging studies. In fat-poor lesions, however, the diagnosis is difficult and presumed a renal cell carcinoma. Yet, some variants of RAML, though rare, express an aggressive behavior leading to metastasis and mortality. The challenge lies in the early detection of benign variants and identifying aggressive lesions for proper management. Another challenge is when the vascular tissue component predominates and poses a risk of hemorrhage that may extend to the retroperitoneum in a massive life-threatening condition. The predicament here is to identify the characteristics of tumors at risk of bleeding and provide a prophylactic treatment. According to the clinical presentation, different treatment modalities, prophylactic or therapeutic, are available that span the spectrum of observation, embolization, or surgery. Renal impairment may result from extensive tumor burden or as a complication of the management itself. Improvement of diagnostic techniques, super-selective embolization, nephron-sparing surgery, and late treatment with the mammalian target of rapamycin inhibitors have provided more effective and safe management strategies. In this review, we examine the evidence pertaining to the risks imposed by RAML to the patients and identify merits and hazards associated with different treatment modalities.

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Spontaneous rupture of renal angiomyolipoma during pregnancy

Cited by 10 publications

References 9 publications

Management of renal tumors during pregnancy: case reports

Management of renal tumors during pregnancy: case reports

An update on recent developments in rupture of renal angiomyolipoma

The Risks of Renal Angiomyolipoma: Reviewing the Evidence

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