scholarly journals Partial Nephrectomy for a Massive Sporadic Renal Angiomyolipoma: Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Jacob Albersheim-Carter ◽  
Molly Klein ◽  
Paari Murugan ◽  
Christopher J. Weight
Keyword(s):  
Partial Nephrectomy ◽  
Radical Nephrectomy ◽  
Arterial Embolization ◽  
Hemodynamic Instability ◽  
Renal Angiomyolipoma ◽  
Management Options ◽  
Retroperitoneal Hemorrhage ◽  
Common Benign Tumor ◽  
Renal Artery Embolization ◽  
Segmental Renal Artery

Introduction.Angiomyolipomas are the most common benign tumor of the kidney, associated with Tuberous Sclerosis in 20% of cases and arising sporadically in 80% of cases. Renal angiomyolipomas are neoplasms of mesenchymal origin with varying proportions of vasculature, smooth muscle spindle cells, and adipocytes, making management of such neoplasms a challenging endeavor. Possible management options include partial or radical nephrectomy and segmental renal artery embolization.Case Presentation.A 61-year-old woman admitted for a large retroperitoneal hemorrhage was discovered to have a giant, sporadic, 3818.3 g, 30.0 × 26.5 × 18.0 cm left perinephric angiomyolipoma. Given her hemodynamic instability upon presentation, she underwent segmental arterial embolization, followed by an open left partial nephrectomy. Ten-month follow-up revealed no noticeable loss of renal function.Discussion.Literature review revealed occasional renal angiomyolipomas of comparable size, with all angiomyolipomas larger than this requiring treatment with radical nephrectomy.Conclusion.We show that nephron-sparing surgery may be considered in the treatment of even the largest of renal angiomyolipomas.

scholarly journals Spontaneous Retroperitoneal Hemorrhage (Wunderlich Syndrome) due to Large Upper Pole Renal Angiomyolipoma: Does Robotic-Assisted Laparoscopic Partial Nephrectomy Have a Role in Primary Treatment?

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Achilles Ploumidis ◽  
Ioannis Katafigiotis ◽  
Maria Thanou ◽  
Nikos Bodozoglou ◽  
Labros Athanasiou ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Arterial Embolization ◽  
Primary Treatment ◽  
Young Female ◽  
Minimal Invasive ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Angiomyolipoma ◽  
Retroperitoneal Hemorrhage ◽  
Robotic Assisted ◽  
Elective Setting

Spontaneous rapture with consequent retroperitoneal hemorrhage (Wunderlich’s syndrome) is the complication mostly feared from large renal angiomyolipomas (RAMLs). In hemodynamic stable patients, minimal invasive therapies have superseded open surgery as the mainstay of treatment, with contemporary cases mostly treated by selective arterial embolization. Robotic-assisted laparoscopic partial nephrectomy (RALPN) is an established minimal access treatment that has been used in the past for benign and malignant lesions of the kidney in the elective setting, but rarely in urgent situations as primary treatment. We present a case of a ruptured RAML in a young female treated effectively by RALPN.

scholarly journals Urgent arterial embolization of ruptured renal angiomyolipoma

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Selim Kervancioglu ◽  
Feyza Yilmaz
Keyword(s):  
Transarterial Embolization ◽  
Arterial Embolization ◽  
Renal Angiomyolipoma ◽  
Tumor Rupture ◽  
Retroperitoneal Hemorrhage ◽  
Life Threatening

AbstractThe most undesired complication of renal angi- omyolipoma (AML) is bleeding. Because of tumor rupture, the bleeding can spread to the retroperitoneal field and can be severe enough to be life threatening. We report a case of retroperitoneal hemorrhage caused by a ruptured AML that was successfully treated with transarterial embolization with N-butyl cyanoacrylate.

scholarly journals Sporadic multiple renal angiomyolipoma with lymph node involvement: a case report and literature review

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110017
Author(s):  
Xiaobo Ding ◽  
Meizi Cui ◽  
Tiejun Wang ◽  
Helei Wang ◽  
Xinyu Wang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Tuberous Sclerosis ◽  
Partial Nephrectomy ◽  
Tuberous Sclerosis Complex ◽  
Radical Nephrectomy ◽  
Vena Cava ◽  
Clinical Manifestations ◽  
Lymph Node Involvement ◽  
Renal Angiomyolipoma ◽  
Node Involvement

Angiomyolipoma (AML) is a benign tumor that mainly occurs in the kidneys. Simultaneous involvement of the kidney and local regional lymph nodes is very rare and might be misdiagnosed as a metastasizing malignant cancer. In the present study, a 50-year-old woman was referred to our hospital after a routine health screening ultrasound. Sporadic multiple renal AML with lymph node involvement was suspected based on the clinical manifestations and radiologic features. Partial nephrectomy was performed and a para-inferior vena cava lymph node was removed. The pathologic results confirmed multiple AML with lymph node invasion. We also reviewed the English-language literature regarding renal AML with lymph node involvement. We found that middle-aged women were likely to develop this disease and that loin pain was the main presenting feature. Most patients had no history of tuberous sclerosis complex. Radical nephrectomy was the predominant treatment. No local recurrence or distant metastasis occurred in any patients after radical nephrectomy or partial nephrectomy. In conclusion, renal AML with lymph node involvement is rare but can occur in both patients with tuberous sclerosis complex and those with multiple sporadic AML. Partial nephrectomy should be the first-line treatment, after which further treatment is not necessary.

scholarly journals The Role of Partial Nephrectomy without Arterial Embolization in Giant Renal Angiomyolipoma

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Enis Rauf Coskuner ◽  
Burak Ozkan ◽  
Veli Yalcin
Keyword(s):  
Partial Nephrectomy ◽  
Frozen Section ◽  
Vena Cava ◽  
Young Patients ◽  
Surgical Margin ◽  
Arterial Embolization ◽  
Benign Neoplasm ◽  
Renal Angiomyolipoma ◽  
Increased Risk

Angiomyolipoma is a benign neoplasm composed of varying admixtures of blood vessels, smooth muscle cells, and adipose tissue. Because of an increased risk of spontaneous haemorrhage, surgical approach is needed greater than 4–8 cm size. We here report our partial nephrectomy experience in the 24 cm size giant angiomyolipoma. 26-year-old woman referred to our clinic with a 24 cm size angiomyolipoma in her lower pole of right kidney. The inferior vena cava was deviated to the left by the mass. All the blood tests were normal and we offered her the choices of partial nephrectomy or nephrectomy. Right subcostal approach was used. The patient underwent resection of the mass with a safety region of 1 cm. Frozen section evaluation was consistent with angiomyolipoma and free for surgical margin. Warm ischemia time was 35 min. and intraoperative bleeding volume was 200 cc. Postoperative 2nd day the drain was taken and hospital stay was 4 days. In literature we observed very rare angiomyolipoma cases with such a large dimension treated by partial nephrectomy without arterial embolization. If technically suitable partial nephrectomy is the main chioce in this kind of benign lesions in young patients.

Renal Angiomyolipoma: Superselective Arterial Embolization and Long Term Follow-up

1997 ◽  
Vol 37 (1) ◽  
pp. 71
Author(s):  
Young Hwan Lee ◽  
Young Min Han ◽  
Chong Soo Kim ◽  
Gyung Ho Chung ◽  
Sang Yong Lee ◽  
...  
Keyword(s):  
Arterial Embolization ◽  
Renal Angiomyolipoma ◽  
Long Term Follow Up

Advanced Management Options for Massive and Submassive Pulmonary Embolism

2016 ◽  
Vol 10 (1) ◽  
pp. 30 ◽  
Author(s):  
Sonika Malik ◽  
◽  
Anju Bhardwaj ◽  
Matthew Eisen ◽  
Sanjay Gandhi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Vena Cava ◽  
Right Ventricular Dysfunction ◽  
Hemodynamic Instability ◽  
Adverse Outcomes ◽  
Intermediate Risk ◽  
Management Options ◽  
Vena Cava Filters ◽  
Submassive Pulmonary Embolism ◽  
Risk Patients

Pulmonary embolism (PE) is an important cause of morbidity and mortality and presents with significant diagnostic and therapeutic challenges. Clinical presentation ranges from mild, nonspecific symptoms to syncope, shock, and sudden death. Patients with hemodynamic instability and/ or signs of right ventricular dysfunction are at high risk for adverse outcomes and may benefit from aggressive therapy and support. Therapeutic anticoagulation is indicated in all patients in the absence of contraindications. Thrombolysis should be strongly considered in selected high- and intermediate-risk patients, either by systemic infusion or percutaneous catheter-directed therapy. Other therapeutic modalities, such as vena cava filters and surgical embolectomy, are options for patients who fail or cannot tolerate anticoagulation and/or thrombolysis. This article reviews the assessment and advanced management options for acute PE with focus on high- and intermediate-risk patients.

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