RENAL ANGIOMYOLIPOMA - EXPERIENCE OF 20 YEARS IN TAIWAN

Objective: 32 cases of renal angiomyolipoma were presented. Diagnosis, treatment and prognosis of the 32 cases were discussed. Material and methods: A total of 32 cases of renal angiomyolipoma treated at the Ve terans General Hospital-Taipei between 1974 and 1994 were retrospectiv ely reviewed. Follow-up periods ranged from 2 to 108 months (mean 43.4 ). Results: Of the 32 cases, 26 were female, 28 were unilateral lesion s and 2 were associated with tuberous sclerosis. The tumor size averag ed 6.73 cm (range 2-25). The mean age was 48.3 years. There was a typi cal image finding in 87.5% of the 28 unilateral tumors. Tumors larger than 4 cm had a greater incidence of symptoms (90%) and a higher nephr ectomy rate (18/22). 30 cases underwent surgery including 22 nephrecto my, 1 partial nephrectomy and 7 enucleation. The nephrectomy rate decr eased from 90% (9/10) to 59.1% (13/22) after 1985. Only 1 patient had a contralateral recurrence 26 months after surgery. Two cases had unus ual presentations, which were perirenal capsule invasion and renal vei n extension, respectively. Conclusions: Our experience with angiomyoli poma in the past 20 years showed that the advancement of imaging techn ology has much improved the diagnosis of this tumor. A correct diagnos is is possible in most cases before surgery. The nephrectomy rate has markedly decreased in recent years. Every effort shold be made to pres erve renal tissue in the treatment of this benign tumor.