Angiomyolipoma (AML) is a mesenchymal renal tumor composed of variable proportions of adipose tissue as well as vascular and smooth muscle elements. It can cause important, potentially life-threatening complications. The aim of this case report is to show a conservative treatment modality of this disease. A 50-year-old man underwent ultrasonography and then computed tomography showing the presence of bilateral renal masses of 27.5 × 19.5 × 21 cm on the left kidney and 28.5 × 19.6 × 27.5 cm on the right, respectively. Serum creatinine was normal; an ultrasonography-guided biopsy of the left kidney did not allow a diagnosis with absolute certainty, but was suggestive of AML. The patient also underwent total body magnetic resonance imaging, which was negative for pathological findings. He underwent a strict regime of surveillance with magnetic resonance imaging every 4-5 months, and at the last follow-up he was asymptomatic and serum creatinine was still normal. The management of giant AML is a complex and multifactorial decision. Patients can knowingly choose an active surveillance program, even in case of giant AMLs.

Keywords:
Giant, Renal angiomyolipomas, Conservative treatment
1.
Nelson CP, Sanda MG: Contemporary diagnosis and management of renal angiomyolipoma. J Urol 2002;168:1315-1325.
2.
Bourneville DM: Sclérose tubéreuse des circonvolutions cérébrales: idiotie et épilepsie hémiplégique. Arch Neurol (Paris) 1880;1:81-91.
3.
Lienert AR, Nicol D: Renal angiomyolipoma. BJU Int 2012;110(suppl 4):25-27.
4.
Lane BR, Aydin H, Danforth TL, Zhou M, Remer EM, Novick AC, Campbell SC: Clinical correlates of renal angiomyolipoma subtypes in 209 patients: classic, fat poor, tuberous sclerosis associated and epithelioid. J Urol 2008;180:836-843.
5.
Nese N, Martignoni G, Fletcher CD, Gupta R, Pan CC, Kim H, Ro JY, Hwang IS, Sato K, Bonetti F, Pea M, Amin MB, Hes O, Svec A, Kida M, Vankalakunti M, Berel D, Rogatko A, Gown AM, Amin MB: Pure epithelioid PEComas (so-called epithelioid angiomyolipoma) of the kidney: A clinicopathologic study of 41 cases: detailed assessment of morphology and risk stratification. Am J Surg Pathol 2011;35:161-176.
6.
Froemming AT, Boland J, Cheville J, Takahashi N, Kawashima A: Renal epithelioid angiomyolipoma: imaging characteristics in nine cases with radiologic-pathologic correlation and review of the literature. AJR Am J Roentgenol 2013;200:W178-W186.
7.
Ramon J, Rimon U, Garniek A, Golan G, Bensaid P, Kitrey ND, Nadu A, Dotan ZA: Renal angiomyolipoma: long-term results following selective arterial embolization. Eur Urol 2009;55:1155-1161.
8.
Yamakado K, Tanaka N, Nakagawa T, Kobayashi S, Yanagawa M, Takeda K: Renal angiomyolipoma: relationships between tumor size, aneurysm formation, and rupture. Radiology 2002;225:78-82.
9.
Danforth TL, Lane BR, Novick AC: Conservative management of giant symptomatic angiomyolipomas in patients with the tuberous sclerosis complex. BJU Int 2007;100:794-797.
© 2013 S. Karger AG, Basel
2013
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.