The emergency treatment of renal angiomyolipoma with spontaneous rupture and hemorrhage (Report of 24 cases)

Abstract

Objectives To investigate the emergency treatment of renal angiomyolipoma with spontaneous rupture and hemorrhage. Methods A retrospective analysis was made on the clinical data and follow–up of 24 cases of renal angiomyolipoma with spontaneous rupture and hemorrhage.Preoperative ultrasonography and CT scanning had been underwent in all the cases. Renal angiomyolipoma with spontaneous rupture and hemorrhage was diagnosed in 22 patients and renal cell carcinoma with hemorrhage could not be ruled out in the other 2 patients. 3 patients were treated conservatively and 4 patients were treated with selective renal arterial embolization. The other 17 patients were managed with emergency surgical intervation. Results In 3 cases of conservative treatment, 1 case was stable, other 2 cases failed and received sugical intervation. 4 cases were embolized successfully, then hemorrhage disappeared. Operation was performed in 17 patients.Nephrectomy was performed in 4 cases. 13 cases were treated with nephron–sparing surgery (NSS).5 caess underwent retroperitoneal laparoscopic surgery and 8 cases were performed open surgery.All the patients were confirmed to be renal angiomyolipoma with rupture and hemorrhage by pathological examination after operation. 24 cases were followed up for 3 to 72 months, no case was recurred and metastasized. Conclusions Ultrasonography and CT scanning are important methods to diagnose renal angiomyolipoma with rupture. The management of renal angiomyolipoma with rupture includes conservative methods, selective renal arterial embolization and emergency surgical intervation. Key words: Kidney Neoplasms; Angiomyoma; Lipoma; Rupture, Spontaneous; Hemorrhage