Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.202000672
Jornal Vascular Brasileiro
Case Report

Endovascular management of bilateral renal angiomyolipoma in a perimenopausal woman

Manejo endovascular de angiomiolipoma renal bilateral em uma mulher na perimenopausa

Ganesh Govinda Gowda; Maureen Tigga; Ravikumar Banavase Ramesh

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Abstract

Renal angiomyolipoma is a benign and progressive tumor consisting of smooth muscle, fat, and vascular elements and is commonly associated with the tuberous sclerosis complex. Bilateral occurrence is rare and recent evidence suggest strong tumor positivity to female hormones with enlargement during pregnancy and oral contraceptive therapy. Treatment varies from a minimally invasive approach with selective embolization of the renal artery to partial nephrectomy or sometimes even radical nephrectomy. Presented here is a case of bilateral renal angiomyolipoma in 50-year-old lady who was successfully treated with super-selective embolization.

Keywords

angiomyolipoma, kidney, angiography

Resumo

O angiomiolipoma renal é um tumor benigno e progressivo composto por músculo liso, gordura e elementos vasculares, comumente associado ao complexo da esclerose tuberosa. Sua ocorrência bilateral é rara, e evidências recentes sugerem forte positividade do tumor para hormônios femininos, com aumento do tamanho durante a gravidez e uso de contraceptivos orais. O tratamento varia desde uma abordagem minimamente invasiva de embolização seletiva da artéria renal até nefrectomia parcial ou, às vezes, nefrectomia radical. Apresentamos um caso de angiomiolipoma renal bilateral em uma mulher de 50 anos que passou por tratamento bem-sucedido com embolização superseletiva.
 

Palavras-chave

angiomiolipoma, rim, angiografia

References

1 Fittschen A, Wendlik I, Oeztuerk S, et al. Prevalence of sporadic renal angiomyolipoma: a retrospective analysis of 61,389 in- and out-patients. Abdom Imaging. 2014;39(5):1009-13. http://dx.doi.org/10.1007/s00261-014-0129-6. PMid:24705668.

2 Alshehri M, Hakami B, Aljameel N, Alayyaf M, Raheem AA. Sporadic giant renal angiomyolipoma: a case report and literature review of clinical presentation, diagnosis, and treatment options. Urol Ann. 2020;12(2):167-71. http://dx.doi.org/10.4103/UA.UA_26_19. PMid:32565656.

3 Gupta A, Priyadarshi S, Vyas N. Renal sinus angiomyolipoma: a rare case. Urol Ann. 2020;12(2):193-5. http://dx.doi.org/10.4103/UA.UA_134_19. PMid:32565663.

4 Urciuoli P, D’Orazi V, Livadoti G, et al. Treatment of renal angiomyolipoma: surgery versus angioembolization. G Chir. 2013;34(11-12):326-31. PMid:24342162.

5 Vos N, Oyen R. Renal angiomyolipoma: the good, the bad and the ugly. J Belg Soc Radiol. 2018;102(1):41. http://dx.doi.org/10.5334/jbsr.1536. PMid:30039053.

6 Laguna MP. Re: natural history of renal angiomyolipoma (AML): most patients with large AMLs >4cm can be offered active surveillance as an initial management strategy. J Urol. 2016;196(5):1397-8. http://dx.doi.org/10.1016/j.juro.2016.08.045. PMid:27751445.

7 Zhang JQ, Fielding JR, Zou KH. Etiology of spontaneous perirenal hemorrhage: a meta-analysis. J Urol. 2002;167(4):1593-6. http://dx.doi.org/10.1016/S0022-5347(05)65160-9. PMid:11912370.

8 Bissler JJ, McCormack FX, Young LR, et al. Sirolimus for angiomyolipoma in tuberous sclerosis complex or lymphangio-leiomyomatosis. N Engl J Med. 2008;358(2):140-51. http://dx.doi.org/10.1056/NEJMoa063564. PMid:18184959.

9 Fujii Y, Ajima J, Oka K, Tosaka A, Takehara Y. Benign renal tumors detected among healthy adults by abdominal ultrasonography. Eur Urol. 1995;27(2):124-7. http://dx.doi.org/10.1159/000475142. PMid:7744154.

10 Rothberg BEG, Grooms MC, Dharnidharka VR. Rapid growth of a kidney angiomyolipoma after initiation of oral contraceptive therapy. Obstet Gynecol. 2006;108(3 Pt 2):734-6. http://dx.doi.org/10.1097/01.AOG.0000188062.13749.ef. PMid:17018483.

11 Oesterling JE, Fishman EK, Goldman SM, Marshall FF. The management of renal angiomyolipoma. J Urol. 1986;135(6):1121-4. http://dx.doi.org/10.1016/S0022-5347(17)46013-7. PMid:3520013.

12 Ramon J, Rimon U, Garniek A, et al. Renal angiomyolipoma: long-term results following selective arterial embolization. Eur Urol. 2009;55(5):1155-62. http://dx.doi.org/10.1016/j.eururo.2008.04.025. PMid:18440125.
 


Submitted date:
05/21/2020

Accepted date:
09/20/2020

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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