Abstract
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.
Highlights
Angiomyolipoma (AML) is a rare benign neoplasm, typically composed of varying admixtures of blood vessels, smooth muscle cells, and adipose tissue (1)
Computerized tomography of abdomen demonstrated a 24 cm size angiomyolipoma that was arising from the lower pole of the right kidney (Figure 1)
All the blood tests were normal and we offered her the choices of partial nephrectomy or nephrectomy
Summary
Angiomyolipoma (AML) is a rare benign neoplasm, typically composed of varying admixtures of blood vessels, smooth muscle cells, and adipose tissue (1). The average size of these tumors is 2 to 8 cm, with cases involving tumors of up to 20 cm reported in literature [1, 2]. Because of an increased risk of spontaneous haemorrhage, selective transcatheter arterial embolization (TAE) or surgical approach are needed greater than 4 to 8 cm size. We here report our partial nephrectomy experience in the 24 cm size giant angiomyolipoma. A right upper quadrant mass was palpated bimanually. Computerized tomography of abdomen demonstrated a 24 cm size angiomyolipoma that was arising from the lower pole of the right kidney (Figure 1). The inferior vena cava was deviated to the left by the mass. Clear uninvolved plane was found between the mass and the vena cava and dissected. The collecting system and renal defect were closed (Figure 2)
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