Contemporary Experience in the Management of Angiomyolipoma
- 1 November 2010
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Endourology
- Vol. 24 (11), 1883-1886
- https://doi.org/10.1089/end.2010.0223
Abstract
Purpose: We review our single center experience in the management of renal angiomyolipoma (AML) in patients who were treated with active surveillance (AS) or invasive treatment protocols. Patients and Methods: A prospectively evaluated database was reviewed, and we identified 91 patients with the diagnosis of renal AML who presented between June 1985 and February 2009. Patient characteristics, clinical presentation, treatment modalities, and patient outcomes were evaluated. Patients on AS were analyzed for successful completion of the surveillance protocol considering age, symptomatic presentation, and tumor size as potential predictors of invasive treatment. Results: A total of 91 patients with AMLs were identified. The mean patient age was 57 years. Seventy-three (83.9%) patients presented incidentally, and 14 (16%) patients were symptomatic at presentation. Forty-five patients were treated with AS, 4 underwent embolization, and 38 patients had extirpative surgery. After a median follow-up of 54.8 months (range 0.2–211.7 mos), there was a mean growth rate of 0.088 cm/year in the group who were treated with AS. AS failed in three patients. Two patients had retroperitoneal bleeding during the observation period, and one patient manifested an expeditious growth rate of 0.7 cm/year and underwent a radical nephrectomy. Conclusions: AML is a renal tumor that usually exhibits a benign course. Surgical removal and embolization are the standard invasive treatment modalities. AS for AMLs is associated with a slow and consistent growth rate (0.088 cm/year), typically has minimal morbidity, and is a reasonable option in selected patients. Symptomatic presentation and size (>3 cm) are not predictive for necessitating an invasive procedure.Keywords
This publication has 17 references indexed in Scilit:
- Active Surveillance for Renal Cortical NeoplasmsJournal of Urology, 2010
- Renal Angiomyolipoma: Long-term Results Following Selective Arterial EmbolizationEuropean Urology, 2009
- Changing Trends in Presentation, Diagnosis and Management of Renal Angiomyolipoma: Comparison of Sporadic and Tuberous Sclerosis Complex-associated FormsUrology, 2008
- Embolization of renal angiomyolipoma: immediate complications and long-term outcomesClinical Radiology, 2008
- The Role of Partial Nephrectomy for the Management of Sporadic Renal AngiomyolipomaUrology, 2007
- LONG-TERM OUTCOME OF TRANSCATHETER EMBOLIZATION OF RENAL ANGIOMYOLIPOMAS DUE TO TUBEROUS SCLEROSIS COMPLEXJournal of Urology, 2005
- Renal Angiomyolipoma: Long-term Results after Arterial EmbolizationJournal of Vascular and Interventional Radiology, 2005
- Contemporary Diagnosis and Management of Renal AngiomyolipomaJournal of Urology, 2002
- Management of renal angiomyolipoma: a report of 53 casesBJU International, 1999
- Renal angiomyolipoma: selective arterial embolization--effectiveness and changes in angiomyogenic components in long-term follow-up.Radiology, 1997