When benign turns aggressive: renal angiomyolipoma with renal vein invasion

Authors

  • Ricardo Cervantes Zorilla Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Alec Anceno Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Gerardo Fernández Noyola Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Fernando Fernández Varela Gómez Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Marco A. Ascencio Martínez Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • César A. Silva Mendoza Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • César E. Venegas Yáñez Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Daniel Roberto Magdaleno-Rodríguez Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Pedro A. Alvarado Bahena Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Juan C. Vázquez Gonzalez Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Jésus E. Lerma Landeros Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Jorge G. Morales Montor Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Carlos Martínez Arroyo Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Mauricio Cantellano Orozco Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
  • Carlos Pacheco Gahbler Department of Urology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico

DOI:

https://doi.org/10.18203/2349-2902.isj20250152

Keywords:

Angiomyolipoma, Thrombectomy, Laparoscopic nephrectomy and size threshold

Abstract

Angiomyolipoma (AML) is the most common benign kidney tumor, made up of fat, smooth muscle, and abnormal blood vessels. It represents 0.3-3% of kidney tumors and is more common in women. AMLs are typically diagnosed via computed tomography (CT) or magnetic resonance imaging (MRI), with most being asymptomatic and requiring no treatment. However, larger or symptomatic AMLs can cause hematuria, flank pain, or bleeding, necessitating treatments like selective arterial embolization, partial nephrectomy, or active surveillance. Recent studies question the traditional 4 cm intervention threshold, suggesting that larger AMLs may be safely monitored based on individual risk factors. This case report discusses a 47-year-old woman with a 4.1×2.1 cm AML with renal vein invasion, treated successfully with laparoscopic nephrectomy. The findings highlight the need for personalized treatment strategies considering tumor characteristics and patient factors, and emphasize the importance of ongoing renal function monitoring.

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References

Caliò A, Brunelli M, Segala D, Zamboni G, Bonetti F, Pea M, Martignoni G. Angiomyolipoma of the kidney: From simple hamartoma to complex tumour. Pathol. 2022;53(1):129–40. DOI: https://doi.org/10.1016/j.pathol.2020.08.008

Lienert AR, Nicol D. Renal angiomyolipoma. BJU Int. 2020;110(4):25–7. DOI: https://doi.org/10.1111/j.1464-410X.2012.11618.x

Flum AS, Hamoui N, Said MA, Yang XJ, Casalino DD, McGuire BB, et al. Update on the Diagnosis and Management of Renal Angiomyolipoma. J of Urol. 2016;195(4):834–46. DOI: https://doi.org/10.1016/j.juro.2015.07.126

Murray TE, Doyle F, Lee M. Transarterial Embolization of Angiomyolipoma: A Systematic Review. J Urol. 2015;194(3):635–9. DOI: https://doi.org/10.1016/j.juro.2015.04.081

Kheir P, Abdessater M, El Khoury J, Akiel R, El Hachem C, Tawil N, El Khoury R. Renal angiomyolipoma with IVC thrombus: A case report. Int J Surg Case Rep. 2020;70:149–53. DOI: https://doi.org/10.1016/j.ijscr.2020.04.076

Gutiérrez ZG, Tristán A, Nieva J. Angiomiolipoma renal con invasión de vena renal y vena cava inferior. Presentación de un caso y revisión de la literatura. Colombian Urol J. 2020;29(2):99–102. DOI: https://doi.org/10.1055/s-0040-1701277

Liu F, Yuan H, Li X, Tang J, Tian X, Ji K. A new management strategy for renal angiomyolipomas: Superselective arterial embolization in combination with radiofrequency ablation. Annals of Translational Med. 2019;7(23):766-9. DOI: https://doi.org/10.21037/atm.2019.11.63

Mora S, Derweesh I, Meagher M, Javier DJ, Noyes SL, Lane BR. Renal functional outcomes in patients with angiomyolipomas: surveillance vs embolization vs nephrectomy. Urol. 2023;173:119–26. DOI: https://doi.org/10.1016/j.urology.2022.12.010

Fernández PS, Hora M, Kuusk T, Tahbaz R, Dabestani S, Abu GY, et al. A management of sporadic renal angiomyolipomas: a systematic review of available evidence to guide recommendations from the European association of urology renal cell carcinoma guidelines panel. Euro Urol Oncol. 2020;3(1):57–72. DOI: https://doi.org/10.1016/j.euo.2019.04.005

Melo AE, Cunha TM. Renal angiomyolipoma with renal vein thrombosis: An incidental finding. BJR Case Reports. 2016;2(2):20150218. DOI: https://doi.org/10.1259/bjrcr.20150218

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Published

2025-01-28

How to Cite

Zorilla, R. C., Anceno, A., Noyola, G. F., Varela Gómez, F. F., Ascencio Martínez, M. A., Silva Mendoza, C. A., Venegas Yáñez, C. E., Magdaleno-Rodríguez, D. R., Alvarado Bahena, P. A., Vázquez Gonzalez, J. C., Lerma Landeros, J. E., Morales Montor, J. G., Martínez Arroyo, C., Cantellano Orozco, M., & Pacheco Gahbler, C. (2025). When benign turns aggressive: renal angiomyolipoma with renal vein invasion. International Surgery Journal, 12(2), 226–228. https://doi.org/10.18203/2349-2902.isj20250152

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Section

Case Reports