Angiomyolipoma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [3]

Overview

Surgery is not the first-line treatment option for patients with angiomyolipoma. Transcatheter arterial embolization is usually reserved for patients with complicated disease.^[1]

Surgery

Angiomyolipoma do not normally require surgery unless there is life-threatening bleeding.

Transcatheter Arterial Embolization

Proximal Embolization
- These are appropriate for the occlusion of a large lumen without distal migration
Distal Embolization
- These are appropriate for the occlusion of a large lumen with distal migration
Palliative Embolization
- Embolization in patients with end-stage renal disease

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Procedure

Selective catheterization of the branch supplying the angiomyolipoma is achieved via a microcatheter
Contrast is infused through the vessel demarcating tumor filling
Embolization is usually performed using a 50:50 dilution of absolute alcohol in lipiodol
A total of 12 mL is injected under careful angiographic observation to ensure no reflux to vessels supplying renal cortex.

Partial Nephrectomy

Larger angiomyolipomas, that have been symptomatic, can be electively resected with a partial nephrectomy.

References

↑ Lewis JH, Weingold AB (1985). "The use of gastrointestinal drugs during pregnancy and lactation". Am J Gastroenterol. 80 (11): 912–23. PMID 2864852.
↑ ^2.0 ^2.1 ^2.2 ^2.3 ^2.4 Image courtesy of Dr. Andrew Lawson. Radiopaedia(original file [1]). Creative Commons BY-SA-NC

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[pmid2864852-1] Lewis JH, Weingold AB (1985). "The use of gastrointestinal drugs during pregnancy and lactation". Am J Gastroenterol. 80 (11): 912–23. PMID 2864852.

[radio-2] 2.0 ^2.1 ^2.2 ^2.3 ^2.4 Image courtesy of Dr. Andrew Lawson. Radiopaedia(original file [1]). Creative Commons BY-SA-NC

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