The radiological diagnosis and treatment of renal angiomyolipoma—current status

Halpenny, Darragh; Snow, Aisling; McNeill, Graeme; Torreggiani, William C.

doi:10.1016/j.crad.2009.09.014

Cited by 157 publications

(159 citation statements)

References 73 publications

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“…There is also no clear consensus in the literature regarding the embolisation technique and the choice of embolic agent [5]. Liquid embolic agent or particles [4,7,8,10], coils in the inflow artery [7] and a combination of occlusion of the distal vascular bed with particles followed by coil occlusion of the arterial inflow [9] to prevent retrograde filling of the aneurysm have been described.…”

Section: Discussionmentioning

confidence: 99%

“…The fat component appears to be relatively insensitive to the effect of embolisation (Figure 4), whereas the vascular component responds well ( Figure 5). Therefore, the post-treatment size reduction does not always correlate with the success of the procedure [5].…”

Section: Discussionmentioning

confidence: 99%

“…The bleeding originates from the abnormal vascular component that represents the angiogenic portion of the tumour. The risk of bleeding is increased with increasing tumour size, with 4 cm generally the accepted cut-off size for intervention [4,5]. Symptomatic lesions of any size should also be treated [6].…”

Section: Discussionmentioning

confidence: 99%

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Patterns of renal angiomyolipoma regression post embolisation on medium- to long-term follow-up

Patatas¹,

Robinson²,

Ettles³

et al. 2013

BJR

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Results: 13 patients underwent 16 episodes of embolisation. Coils were used as the primary embolisation material in 10 episodes and microspheres in 6 episodes. The size reduction rate highly correlated on CT followup between the two groups, with 25.6% vs 22.7% reduction at 12 months, 27.5% vs 25.1% at 24 months, 35.0% vs 33.0% at 36 months and 35.0% vs 36.8% at 48 months. During follow-up, all tumours reduced in size with one patient requiring subsequent embolisation whose tumour reduced by only 6.5% after 1 year and subsequently exhibited regrowth after 4 years. Two patients presented with rebleeding and underwent repeat embolisation. Our overall retreatment rate (23%) is well within the literature range (up to 37%). None of the patients underwent surgery. Conclusion:The majority of AML shrinkage occurs within the first year following embolisation and appears to plateau after 3 years, which could have an impact on follow-up strategy. The percentage reduction at 1 year may reflect the long-term effect of embolisation with tumours demonstrating minor size reduction more likely to relapse at long-term follow-up. Embolisation of renal AML produces durable long-term results regardless of the choice of embolic agent. Advances in knowledge:These findings provide information to guide CT follow-up of renal AML post embolisation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Patterns of renal angiomyolipoma regression post embolisation on medium- to long-term follow-up

Patatas¹,

Robinson²,

Ettles³

et al. 2013

BJR

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show abstract

“…Ultrasound is fairly accurate for the diagnosis of renal AML, and the typical manifestations are markedly higher echoes accompanied with rear acoustic shadowing, as it is mixed with several tissue components (e.g. fats) and contains rich vascular nets (16,17). In the present case, however, the lesion was hyperechoic, and was combined with the sound shadow behind the marginal calcification, all of which simulated the ultrasonic manifestations of a typical AML.…”

Section: Discussionmentioning

confidence: 51%

Xp11.2 translocation renal cell carcinoma with egg-shell calcification mimicking a benign renal tumour: A case report

Liang

2015

Oncology Letters

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Abstract. The present study reports the case of a 20-year-old female who was identified to have a left renal angiomyolipoma (AML) with hemorrhage. Following temporary conservative observation, the patient received continuous ultrasonic follow-up. Due to the rapid growth of the lesion, further examinations were performed. Computed tomography (CT) plain scans revealed a partly high-density mass with marginal egg-shell calcification. Enhanced CT revealed a solid tumor with a rich blood supply. Since no fats were detected, the possibility of a typical AML was excluded, but the diagnoses of epithelioid AML or renal cancer were considered. Finally, the left kidney was partially excised laparoscopically. The intraoperative frozen section indicated a diagnosis of renal cell carcinoma (RCC). The left kidney was subsequently radically excised. . Routine histopathological and immunohistochemical tests confirmed that the lesion was an RCC with an Xp11.2 translocation. The present study introduces the pitfalls in the diagnosis of Xp11.2 translocation RCC, which is a rare RCC subtype accompanied with uncommon imaging manifestations. The study suggests that when a rapidly-growing AML is detected by ultrasound, renal cancer with marginal calcification should be considered. Moreover, although egg-shell calcification mostly occurs in benign renal lesions, further examinations, such as enhanced CT, are recommended for identifying the nature of the masses and excluding the possibility of malignant tumors.

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“…However, postembolization syndrome, the reduction of tumor volume and the optimal time window for NSS following SAE should be taken into consideration. Postembolization syndrome is a side effect of embolization procedures and consists of one or more of the following symptoms: Flank pain, fever, nausea and vomiting attributable to inflammatory mediators (18,19).…”

Section: Discussionmentioning

confidence: 99%

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

Zhou

Tang

et al. 2015

Oncology Letters

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Abstract. The current report presents the case of a 50-year-old female who presented with a giant bilateral renal angiomyolipoma (AML). After assessing the patient's symptoms, the tumor size and renal function, the patient underwent a total nephrectomy for the right AML, which measured 28x20x14 cm and nephron-sparing surgery was performed without preoperative selective angiographic embolization for a further 3 AMLs in the left kidney, the largest of which had a diameter of 12 cm. The introperative bleeding volume was at an acceptable level and the renal function was stable. No local recurrence was observed and no dialysis was required during follow-up. The strategy of the treatment in this report should be considered when treating similar tumors.

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The radiological diagnosis and treatment of renal angiomyolipoma—current status

Cited by 157 publications

References 73 publications

Patterns of renal angiomyolipoma regression post embolisation on medium- to long-term follow-up

Patterns of renal angiomyolipoma regression post embolisation on medium- to long-term follow-up

Xp11.2 translocation renal cell carcinoma with egg-shell calcification mimicking a benign renal tumour: A case report

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

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