1798 RENAL EPITHELIOID ANGIOMYOLIPOMA: A RARE VARIANT WITH UNUSUAL BEHAVIOR

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You have accessJournal of UrologyKidney Cancer: Localized (V)1 Apr 20131798 RENAL EPITHELIOID ANGIOMYOLIPOMA: A RARE VARIANT WITH UNUSUAL BEHAVIOR Mohammed Hassan, Ahmed El-Hefnawy, Ahmed Elshal, Ahmed Mosbah, and Attalah Shaaban Mohammed HassanMohammed Hassan Mansoura, Egypt More articles by this author , Ahmed El-HefnawyAhmed El-Hefnawy Mansoura, Egypt More articles by this author , Ahmed ElshalAhmed Elshal Mansoura, Egypt More articles by this author , Ahmed MosbahAhmed Mosbah Mansoura, Egypt More articles by this author , and Attalah ShaabanAttalah Shaaban Mansoura, Egypt More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2848AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Epithelioid angiomyolipoma (EAML) is a rare renal tumor in which the epithelioid component comprises more than 10% of the tumor. Data on its clinical presentation and prognosis is still lacking. We compared the clinical, pathological and oncological out come of EAML with classic Angiomyolipoma (AML). METHODS A retrospective analysis of patients' files with a diagnosis of AML were compared with those who had EAML. Both groups were compared as regard the patients' demographics, mode of presentation and tumor criteria. Patient's survival was compared. In addition, the accuracy of preoperative radiological diagnosis of EAML is evaluated. Statistical analysis was conducted using Chi-square test for categorical variables, independent t test for continuous variables. RESULTS Between November 1988 and July 2012, 1502 renal masses were treated. Forty-three (2.8%) patients had renal AML of whom 12 (27.9%) had epithelioid variant. Renal colic was the commonest symptoms in both groups. While incidental masses was found in 16% in AML, none of EAML group was discovered incidentally (P = 0.04) (Table-1). In EAML, computed tomography with contrast identified fat contents in 4 cases; suggestive AML, however, specific diagnosis of EAML was not suggested based on radiological evaluation. In one patient, there was a venous tumor extension into the right renal vein. Five patients (42%) underwent nephron sparing nephrectomy while 7 patients underwent radical nephrectomy. At a mean follow up of 16.2 ± 12.4 month (2-42 months) one patient with EAML had evidence of local recurrence at 3 months after open radical nephrectomy. Local recurrence of epithelioid AML was histopathologically confirmed.on the other hand none of the patients with AML developped local recurrence. CONCLUSIONS Epithelioid AML has tendency towards malignant-like behavior. It may be misdiagnosed with malignant renal mass on preoperative clinical or radiological evaluation. Patient demographics, clinical presentation and tumor criteria (Table 1) AML Epithelioid AML P value Number 31 (72%) Number 12 (28%) a Age (years) 0.50 Mean ± SD 46 ± 14 49 ± 11 b Sex 0.59 male 11 (33%) 4 (33%) female 20 (67%) 8 (67%) Presentation ⁎0.04 Incidental 5 (16.1%) 0 Hematuria 2 (6.5%) 3 (25%) Pain 21 (67.7%) 5 (41.7%) Multiple 3 (9.7%) 4 (33.3%) Tumor Side 0.61 Right 15 (48.4%) 7(58.3%) Left 14 (45.2%) 5 (41.7%) Bilateral 2 (6.5%) 0 Site 0.26 Upper 4 (12.9%) 2 (16.7%) Midzone 7 (22.6%) 5 (41.7%) Lower 8 (25.8%) 4 (33.3%) Multiple 10 (32.3%) 1 (8.3%) Replaces the kidney 2 (6.5%) 0 Size (cm) 0.74 mean ± SD 8.3 ± 7.1 9.1 ± 6 a: Independent t-test b: Chi-square test. ⁎ Significant P< 0.05. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e739 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohammed Hassan Mansoura, Egypt More articles by this author Ahmed El-Hefnawy Mansoura, Egypt More articles by this author Ahmed Elshal Mansoura, Egypt More articles by this author Ahmed Mosbah Mansoura, Egypt More articles by this author Attalah Shaaban Mansoura, Egypt More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...