RENAL ANGIOMYOLIPOMA - EMBOLOTHERAPY WITH A MIXTURE OF ALCOHOL AND IODIZED OIL

PURPOSE: To evaluate the efficacy of superselective embolotherapy of r enal angiomyolipomas with a 1:3 mixture of iodized oil and absolute et hanol as embolic material. MATERIALS AND METHODS: Fifteen patients wit h 21 symptomatic renal angiomyolipomas were treated with embolization. The sizes of tumors ranged from 6 cm to 15 cm (mean, 8.6 cm). Six of 15 patients were diagnosed with tuberous sclerosis, The diagnoses of r enal angiomyolipoma were made from characteristic computed tomographic findings, All angiomyolipomas were successfully embolized with a 1:3 mixture of iodized oil and absolute ethanol (2-20 mL; mean, 8.5 mL). P atients were followed up from 5 months to 8 years (mean, 35.6 months), The efficacy of embolotherapy was evaluated by symptom-free period, i mmediate and late complications, and follow-up imaging findings, inclu ding changes in tumor size. RESULTS: Thirteen patients showed no sympt om recurrence during follow-up periods from 3 months to 8 years. Two p atients with incomplete embolization required repeated embolization be cause of the recurrence of perinephric hematoma or other symptoms. Twe lve patients experienced mild postembolization syndrome, which subside d with conservative management, A moderate amount of pleural effusion developed in one patient and was managed with percutaneous drainage, N o patients developed any severe late complications, hypertension, or r enal failure. During the follow-up period, 12 tumors decreased in size , whereas there was no change in eight tumors, and in one tumor imagin g follow-up was not available.CONCLUSION: Embolization with a 1:3 mixt ure of iodized oil and absolute ethanol is an effective method of trea tment in renal angiomyolipoma with favorable results, But incomplete e mbolization of angiomyolipoma results in a high incidence of recurrent symptoms due to bleeding.