Management of symptomatic renal angiomyolipoma: a review of 7 cases

Abstract

Introduction: Angiomyolipoma (AML) is a benign renal tumor that occasionally requires intervention. Diagnosis and treatment of 7 cases were discussed.

Patients and method: A total of 7 cases with diagnosis of symptomatic angiomyolipoma at Maharaj- nakorn chiangmai hospital from January 2004 to May 2005 were reviewed. Of 7 cases, 6 were female (86%). The mean age was 31.6 yrs (range 22-60 yrs). Clinical symptoms were dominated by palpable mass and flank pain (71%). The diagnosis of every cases was established by CT scan. The tumor size was 15.0 cm. in average (range 8.5-28 cm.). The treatment was consisted of elective partial nephrectomy in 3 cases, emer- gency total nephrectomy in 1 case and emergency renal embolization in 3 cases.

Result: All cases had no post operative or post embolization serious complication, and no dialysis was required. In the follow-up period, all three cases in partial nephrectomy group had no related symptom and no residual tumor in follow-up CT scan. All cases that had embolized kidney had only mild flank pain post renal embolization and the tumor size of 2 cases was decreased by follow-up CT scan.

Conclusion: The management of angiomyolipoma should be aimed at parenchyma preservation which can be effectively accomplished by limited surgery (partial nephrectomy) or preferably by embolization. Partial nephrectomy or renal embolizations are effective in symptomatic angiomyolipoma, but elective partial nephrectomy post embolization or second embolization may be required.