Is cryoablation safe and effective in patients with renal angiomyolipomas?
Angiomyolipoma of the Kidney. Angiomyolipoma is a condition in which benign tumors form in your kidney. You may have no symptoms, or you may have anemia, fever, pain or high blood pressure. Tumors that grow may need treatment such as embolization or surgery to reduce the risk of bleeding. Urology 216.444.5600.
What is angiomyolipoma AML?
Background: Small series have reported that cryoablation (CA) is a safe and feasible minimally invasive nephron-sparing alternative for the treatment of renal angiomyolipomas (renal AMLs). The aim of the present study was to investigate the safety and efficacy of CA in patients with renal AML. Materials and methods: A retrospective review of 19 renal AML lesions treated with …
What is the prognosis of asymptomatic angiomyolipomas?
After the diagnosis is established, patients should be monitored with renal imaging at regular intervals to identify rapid-growing tumors. As an alternative to current treatment modalities such as partial nephrectomy and super selective angioembolization, cryoablation is an emerging approach, although experience with pediatric patients is limited.
What are the treatment options for renal angiomyolipoma?
Dec 16, 2013 · Renal angiomyolipoma (AML) is a benign mesenchymal tumour. AML often leads to haemorrhagic complications such as retroperitoneal haematoma. Treatment varies from case to case, ranging from minimally invasive approaches such as selective embolization of the renal artery to invasive wedge resection, partial nephrectomy or, in more severe cases, radical …
Why is radical nephrectomy indicated only for the treatment of AMLs?
Due to high morbidity related to the possible occurrence of renal insufficiency, radical nephrectomy is indicated only for the treatment of AMLs >8 cm (22), when suspicion of malignancy is high and when minimally invasive techniques cannot be performed (11).
What are the complications of AML?
Retroperitoneal haemorrhage and/or bleeding into the renal collecting system are the major complications of AML; both conditions may put the patient’s life at risk.
What is TSC in AML?
TSC is an autosomal dominant neurocutaneous disorder that may affect several organs, e.g. brain, skin, eyes, heart, kidney and lungs. AMLs and renal cysts represent the renal manifestation of this syndrome (2). TSC is diagnosed in 20% of all renal AML cases (3), 80% of which present as bilateral or multiple lesions (4–6).
What is angiomyolipoma?
Angiomyolipoma (AML) is the most frequent mesenchymal tumour of the kidney, composed of vascular, smooth muscle and fat elements . AML has an incidence of 0.1–0.22% in the general population, and is four times more frequent in women than in men (1). The lesions may present as sporadic cases or in association with tuberous sclerosis complex (TSC).
What is the diameter of a haematoma?
Diagnosis was confirmed both by contrast-enhanced and non-contrast CT scan of the upper and lower abdomen, which showed the presence of a copious serohaematic retroperitoneal collection mainly located in the anterior peri-renal space and along the right parietal colic sulcus, with a diameter of 83.96 mm × 48.84 mm, extending to the pelvis. The haematoma also extended to the vena cava, to the second duodenal portion, to the lower liver margin, encompassing the entire proximal-middle tract of the ureter on the same side. No active bleeding was documented during the arterial and venous contrast phases. On CT scan, right kidney contour presented irregular margins owing to the presence of a hypodense lesion at the lower third of the anterior surface of the kidney, with a maximum diameter of 46.65 mm × 24 mm, that had likely caused the adjacent bleeding (Figs. 1, ,22).
How to diagnose AML?
In the majority of cases, classic AML is easily diagnosed by recognition of fat tissue within the lesion, which appears hyperechoic on ultrasound, as an area of negative attenuation value on CT and as an area of high signal intensity on T1-weighted images with signal loss on MRI (17 , 18). Recognizing the fat component is therefore essential to rule out a diagnosis of malignant renal tumour such as renal cell carcinoma (RCC), as well as of lipomas, liposarcomas and fat-containing RCCs (7). A percutaneous renal biopsy can be helpful in dubious cases (19).
Is renal AML a benign tumor?
Renal AML is considered as a benign kidney tumour with hamartomatous features. AML is composed of heterogeneous tissues, including blood vessels, adipose tissue and smooth muscle, and may present as sporadic cases or in association with TSC.
What is the treatment for renal angiomyolipoma?
The natural history of renal angiomyolipoma is not well delineated. Current management options include observation, embolization, and partial or total nephrectomy. Recommendations for treatment are usually based on the patient's symptoms or the size of the lesion. In an effort to help define the opt …
How many cm are angiomyolipomas?
Angiomyolipomas greater than 8 cm were responsible for significant morbidity and generally require treatment (5/6). Patients with tuberous sclerosis made up one half (3/6) of the large lesions.
What is angiomyolipoma?
Angiomyolipomas (AMLs) belong to a family of tumors collectively referred to as neoplasms with perivascular epithelioid differentiation (or PEComas) [ 1 ]. These tumors arise by clonal proliferation of epithelioid cells distributed around blood vessels [ 2 ]. Renal AMLs may occur in association with tuberous sclerosis complex (TSC) ...
What are AMLs in the kidney?
Pathogenesis of AMLs and disease associations — AMLs are lesions of the kidney comprised of smooth-muscle-like cells, adipocyte-like cells, and epithelioid cells. The three cell types appear to be derived from pericytes. This is suggested by the fact that they all express pericyte markers (angiotensin II type 1 receptor, platelet-derived growth factor receptor-beta, desmin, alpha - smooth muscle actin, and vascular endothelial growth factor [VEGF] receptor 2) but not the endothelial cell marker CD31 or the adipocyte marker S-100 [ 3 ].
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What is the treatment for pulmonary embolism?
Treatment of pulmonary embolism is aimed at keeping the blood clot from getting bigger and preventing new clots from forming. Prompt treatment is essential to prevent serious complications or death.
What is a blood clot tracer?
The tracer maps blood flow (perfusion) and compares it with the airflow to your lungs (ventilation) and can be used to determine whether blood clots are causing symptoms of pulmonary hypertension.
How accurate is a pulmonary embolism test?
This test provides a clear picture of the blood flow in the arteries of your lungs. It's the most accurate way to diagnose pulmonary embolism, but because it requires a high degree of skill to administer and has potentially serious risks, it's usually performed when other tests fail to provide a definitive diagnosis.
What is a CT scan?
CT scanning generates X-rays to produce cross-sectional images of your body. CT pulmonary angiography ― also called CT pulmonary embolism study ― creates 3D images that can detect abnormalities such as pulmonary embolism within the arteries in your lungs.
Why is it important to keep on blood thinners?
Because you may be at risk of another deep vein thrombosis or pulmonary embolism, it's important to continue treatment, such as remaining on blood thinners, and be monitored as often as suggested by your doctor. Also, keep regular doctor visits to prevent or treat complications.
Where to get pulmonary embolism evaluated?
Preparing for your appointment. Pulmonary embolism is often initially evaluated in hospitals, emergency rooms or urgent care centers. If you think you might have a pulmonary embolism, seek immediate medical attention.
What does a blood test measure?
Blood tests also can measure the amount of oxygen and carbon dioxide in your blood. A clot in a blood vessel in your lungs may lower the level of oxygen in your blood. In addition, blood tests may be done to determine whether you have an inherited clotting disorder.