Contemporary Diagnosis and Management of Renal Angiomyolipoma

No AccessJournal of UrologyCLINICAL UROLOGY: Review Articles1 Oct 2002Contemporary Diagnosis and Management of Renal Angiomyolipoma Caleb P. Nelson and Martin G. Sanda Caleb P. NelsonCaleb P. Nelson and Martin G. SandaMartin G. Sanda View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64440-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We present a comprehensive resource that summarizes contemporary advances relevant to the clinical management of renal angiomyolipoma. Materials and Methods: A MEDLINE search was done using the key words angiomyolipoma, hemangioma or lipoma and kidney neoplasm, and therapeutic embolization. References from these articles were reviewed to identify additional relevant source material. We identified 13 series published since 1986 comprising 336 patients as well as 24 reports of therapeutic embolization for angiomyolipoma, comprising 76 patients. To our knowledge we report the largest compilation series to date. Results: Angiomyolipoma is generally benign, although an uncommon subtype (epithelioid angiomyolipoma) may behave more aggressively. Tuberous sclerosis associated angiomyolipoma tends to be larger, multiple and more likely to cause spontaneous hemorrhage than the sporadic entity. Tumors that hemorrhage tend to be larger. Computerized tomography or magnetic resonance is usually sufficient for diagnosis. Biopsy is rarely useful. Primary indications for intervention include symptoms such as pain or bleeding or suspicion of malignancy. Prophylactic intervention is justifiable for large tumors, in females of childbearing age or in patients in whom followup or access to emergency care may be inadequate. Recent advances that have affected management include improved understanding of tuberous sclerosis complex and angiomyolipoma genetics, the identification of molecular markers that facilitate histopathological diagnosis, and the refinement of embolization and partial nephrectomy techniques. Conclusions: Although some cases of angiomyolipoma may require complete nephrectomy, most can be managed by conservative nephron sparing approaches. Ongoing research into the molecular biology and clinical behavior of angiomyolipoma may improve our ability to manage these lesions. References 1 : Angiomyolipoma of the kidney. J Urol1951; 65: 525. Link, Google Scholar 2 : Atlas of Genitourinary Pathology. Washington, D. C: Army Institute of Pathology1946. Google Scholar 3 : Demonstration eines grossen Angio-Myo-Lipoms der Niere. Dtsch Med Wochenschr1900; 26: 290. Google Scholar 4 : Extrarenal angiomyolipoma. J Surg Oncol1984; 25: 89. Google Scholar 5 : Renal angiomyolipomas of the perinephric space. 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Volume 168Issue 4 Part 1October 2002Page: 1315-1325 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsembolization, therapeuticangiomyolipomakidneytuberous sclerosisnephrectomyMetricsAuthor Information Caleb P. Nelson More articles by this author Martin G. Sanda More articles by this author Expand All Advertisement PDF downloadLoading ...