MANAGEMENT OF RENAL ANGIOMYOLIPOMA - ANALYSIS OF 15 CASES

Objective: We present our experience with 15 patients with renal angio myolipoma warranting intervention. Methods: The medical records and ra diological studies were reviewed for patient age and sex, tumor locati on and size, association with tuberous sclerosis, and treatment approa ch. All patients were regularly followed by ultrasound and computed to mography scan. Results: Presenting symptoms were retroperitoneal bleed ing in 9 patients and flank pain in 6. Excluding cases of tuberous scl erosis (mean tumor diameter 11 cm), the mean diameter of the two tumor s that bled was 5.4 cm, similar to those in the patients presenting wi th flank pain. Two patients with retroperitoneal bleeding had tumors < 3 cm. Angioinfarction was performed in 7 patients, partial nephrectom y in 3, and total nephrectomy in 4. One patient with tuberous sclerosi s, who was observed only, died of bleeding and sepsis. The mean follow -up period of 4.3 years revealed stable creatinine levels and no recur rent hemorrhage. Conclusions: The management approach of angiomyolipom a should be aimed at parenchymal preservation which can be effectively accomplished by limited surgery or preferably by selective embolizati on. Preventive embolization may be feasible even for small tumors. How ever, any doubt about the diagnosis of angiomyolipoma should be clarif ied by surgery.