Angiomyolipoma natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [3], Faizan Sheraz, M.D. [4]
Overview
If left untreated, small angiomyolipomas and those without dilated blood vessels (aneurysms) cause few symptoms. Small angiomyolipomas are associated with the most favorable prognosis. Common complications of angiomyolipoma include infection, hemorrhage, and shock.
Natural History
If left untreated, small angiomyolipomas and those without dilated blood vessels (aneurysms) cause few problems. Angiomyolipomas grow as rapidly as 4 cm in one year.It has been observed in some studies that the female sex hormones has positive impact on the size of the angiomyolipoma.There has been increased growth and hemorrhagic complications seen during the pregnancy as well as after treatment with exogenous hormonal therapy.[1][2][3][4][5].Due to increased rate of growth of Angiomyolipoma and increased risk of its rupture, it is advised to use estrogen cautionally in these patients, and frequent imaging surveillance every six months initially and annual thereafter, once stablised,is recommended.
Complications
Common complications of angiomyolipoma include:
- Infections
- Urinary obstruction
- End stage renal failure, in case of bilateral angiomyolipoma
- Intestinal obstruction
- Shock
- Hemorrhage
- Rarely, it can transform into malignant Angiomyolipoma, especially if related to Tuberous Sclerosis
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![Retroperitoneal hemorrhage from renal angiomyolipoma.[6]](/images/7/7e/Retroperitoneal-haemorrhage-from-renal-angiomyolipoma.jpg)
Retroperitoneal hemorrhage from renal angiomyolipoma.[6]
![Retroperitoneal hemorrhage from renal angiomyolipoma.[6]](/index.php/File:Retroperitoneal-haemorrhage-from-renal-angiomyolipoma.jpg)
Prognosis
Small angiomyolipomas are associated with the most favorable prognosis. An angiomyolipoma larger than 5 cm and those containing an aneurysm pose a significant risk of rupture, which is a medical emergency as it is potentially life-threatening. Cumulative risk of hemorrhage is estimated to be:
- 10% among males
- 20% among females
References
- ↑ Gould Rothberg BE, Grooms MC, Dharnidharka VR (2006). "Rapid growth of a kidney angiomyolipoma after initiation of oral contraceptive therapy". Obstet Gynecol. 108 (3 Pt 2): 734–6. doi:10.1097/01.AOG.0000188062.13749.ef. PMID 17018483.
- ↑ Lewis EL, Palmer JM (1985). "Renal angiomyolipoma and massive retroperitoneal hemorrhage during pregnancy". West J Med. 143 (5): 675–6. PMC 1306454. PMID 4082575.
- ↑ Zapardiel I, Delafuente-Valero J, Bajo-Arenas JM (2011). "Renal angiomyolipoma during pregnancy: review of the literature". Gynecol Obstet Invest. 72 (4): 217–9. doi:10.1159/000329328. PMID 21876331.
- ↑ Raft J, Lalot JM, Meistelman C, Longrois D (2006). "[Renal angiomyolipoma rupture during pregnancy]". Gynecol Obstet Fertil. 34 (10): 917–9. doi:10.1016/j.gyobfe.2006.02.021. PMID 16996772.
- ↑ Vandenesch F, Surgot M, Bornstein N, Paucod JC, Marmet D, Isoard P; et al. (1990). "Relationship between free amoeba and Legionella: studies in vitro and in vivo". Zentralbl Bakteriol. 272 (3): 265–75. PMID 2184818.
- ↑ Image courtesy of Dr Matt A. Morgan and Dr Behrang Amini et alRadiopaedia(original file [1]). Creative Commons BY-SA-NC