Angiomyolipoma managed by partial nephrectomy: Outcomes and follow-up

Authors : R B Nerli, R B Nerli, Adarsh C Sanikop, Adarsh C Sanikop, Sushant Deole, Sushant Deole, Sreeharsha Nutalapati, Sreeharsha Nutalapati, Shridhar C Ghagane, Shridhar C Ghagane

DOI : 10.18231/j.ijpo.2020.086

Volume : 7

Issue : 3

Year : 2020

Page No : 435-440

Introduction: Angiomyolipoma (AML) is a benign neoplasm and consists of thick-walled poorly
organized blood vessels, smooth muscle, and varying levels of mature adipose tissue. We evaluated the
impact of clinical characteristics, particularly tumor diameter, and surgical treatment in the form of partial
nephrectomy on the outcome of sporadic renal AML.
Materials and Methods: Patients undergoing partial nephrectomy during the period Jan 2000 to Dec 2016
with a final diagnosis of angiomyolipoma formed the study group. Patient demographic data was collected,
and data from during and after surgery was also reviewed.
Results: The median age of the patients was 51 (38-55) years. At presentation, most patients were
asymptomatic (6/8, 75%) with the AML presenting as an incidental finding on imaging done for other
reasons. There was classical triphasic AML, consisting of elements of adipose tissue, smooth muscle and
abnormal blood vessels, in 5/10 tumours (50%). The more aggressive epitheliod variant AML was present
in 2/10 (20%). The median follow-up of the patients was 38 (29-64) months. During the follow-up period
one (12.5%) patient who had two lesions progressively showed evidence of rising creatinine and decreasing
creatinine clearance.
Conclusions: AML is a benign renal neoplasm and should be treated initially conservatively. Surgical
intervention when required should be nephron sparing so as to reduce the incidence of perioperative
complications, loss of renal units, and development of CKD.

Keywords: Angiomyolipoma, Nephron sparing surgery, Renal mass.


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