Yonsei Med J.  2010 Sep;51(5):728-734. 10.3349/ymj.2010.51.5.728.

Trends of Presentation and Clinical Outcome of Treated Renal Angiomyolipoma

• Koo KC
• Kim WT
• Ham WS
• Lee JS
• Ju HJ
• Choi YD

• KMID: 1071425
• DOI: http://doi.org/10.3349/ymj.2010.51.5.728

Abstract

PURPOSE
The purpose of this study is to set guidelines for the management of renal angiomyolipoma (AML), clinical prognosis according to tumor size, in association with tuberous sclerosis complex (TSC), multiplicity, radiographic finding, and treatment modality.
MATERIALS AND METHODS
Between March 1998 and October 2008, 129 out of 254 patients with AML who underwent surgical intervention or angioembolization were enrolled. Diagnosis of AML was determined by the presence of a low attenuated component on CT imaging or by pathological confirmation. Indications of treatment were intractable pain, hematuria, suspicion of malignancy, large tumor size, spontaneous rupture, and radiographically equivocal tumors in which a differential diagnosis was needed to rule out malignancy. Parameters including age, sex, tumor size, multiplicity, radiographic characteristics, association with TSC, and treatment modality were reviewed.
RESULTS
Age at presentation was 50.6 years and mean tumor size was 3.5 cm. Presentation symptoms were flank pain, hematuria, spontaneous rupture, and fatigue. 97 (75.2%) patients were incidentally discovered. 100 (77.5%) were females. 68 (52.7%) underwent nephron-sparing surgery (NSS), 35 (27.1%) radical nephrectomy, and 26 (20.2%) angioembolization. TSC was accompanied in 12 (9.3%) patients. No patient developed renal function impairment during the mean follow-up period of 64.8 months. Patients with TSC presented at a younger age, along with larger, bilateral, and multiple lesions.
CONCLUSION
Significant differences in clinical manifestations and treatment outcomes were noted in respect to tumor characteristics, association with TSC, and treatment modality. Considering the benign nature of AML, these parameters ought to be considered when deciding upon active surveillance or prophylactic intervention.

Keyword

Angiomyolipoma; tuberous sclerosis; kidney

MeSH Terms

Adult
Angiomyolipoma/*pathology/*surgery/therapy
Female
Humans
Kidney Neoplasms/*pathology/*surgery/therapy
Male
Middle Aged
Retrospective Studies
Treatment Outcome

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