Clinical Course of Renal Angiomyolipoma

Min, Jun Ki; Kim, Hyung Jin

Abstract

Renal angiomyolipomas are uncommon benign neoplasms. From April 1990 to June 1993, 10 patients with angiomyolipoma were followed clinically to determine the clinical course of angiomyolipoma. Average age of patient was 50 years( range 24 to 75) and of the patients 80% were women, 10% had tuberous sclerosis and the average size of the renal mass was 9.l x 6cm ( range 2x1.5 to 13.8 x 9.1). Clinically the most common presenting complaint was abdominal/ flank pain and of the patients 40% were spontaneous rupture, 2 cases had hemorrhagic shock. The diagnosis and size was determined on the basis of ultrasonography/CT findings. Of 10 patients, 1 patient was observed, 3 patients were managed with nephrectomy and 6 patients were managed with embolization. 10 patients were followed for an average 28 months( range of 12 to 50) by serial radiological imaging and clinical examination. The followup ultrasonography and/or CT scans were compared to the initial studies with respect to hemorrhage, or change in size or composition of the tumor. One patient was managed with observation, symptoms developed and tumor size increased 35 months later. 3 patients were free of disease for 20 to 50 months after nephrectomy. 5 of 6 patients managed with embolization, a radiological examination performed after the embolization demonstrated the original mass had liquefied and decrease in mass size. But 1 patient did not change in size and composition. These results demonstrate the selective embolization is an effective method as the primary therapy for control of hemorrhagic or symptomatic angiomyolipomas because of its parenchymal-sparing nature.