Renal angiomyolipoma
This article, written by a team of urologists and surgeons from our clinic, aims to inform patients who have encountered a renal angiomyolipoma about the dangers of this condition, as well as modern methods of its diagnosis and treatment.
The
diagnosis of "renal angiomyolipoma" comes as an unpleasant surprise
to anyone. Imagine during a routine check-up or simply visiting a clinic with
mild lower back pain, leaving the ultrasound room with the conclusion of
"kidney tumor." Proving that this tumor is benign still needs to be
done.
Even worse, the presence of an angiomyolipoma poses the risk of bleeding, tumor rupture,and often, lower back pain.
A renal angiomyolipoma is a benign tumor composed of fatty tissue and transformed blood vessels and epithelial cells. It often has small dimensions, but there are also large and even huge lipomas capable of invading the renal vein or, rarely, the inferior vena cava.
"Just because a tumor is called benign doesn't mean it can't seriously harm health."
Angiomyolipoma
has a particular characteristic: its blood vessels are defective and prone to
forming aneurysms, which can rupture without any apparent cause. This factor
compels us to closely monitor the patient and recommend surgical intervention
as the size increases.
Bleeding: As mentioned, the blood vessels of the lipoma are defective and often form aneurysms. Hence, there's a high risk of bleeding into the renal pelvis or the retroperitoneal space, requiring emergency surgery.
Pain: Enlargement of this voluminous formation can lead to compression of the kidney, muscles, and nerves, resulting in pain. Constant, debilitating pain often requires pain relief medication.
Invasion of veins:One of the worst complications: the growth of any tumor, including lipoma, can damage the renal or even the inferior vena cava. This poses the risk of a life-threatening complication: pulmonary artery thromboembolism.
Tuberous sclerosis:Angiomyolipomas can form not only in isolation but also in the context of genetic disorders such as tuberous sclerosis. Therefore, when a lipoma is found, we conduct detailed examinations to exclude this serious condition.
Kidney function: Impairment of kidney function is typical for lipomas and any formations larger than 4 centimeters. These tumors compress renal tissue, depriving the organ of nutrients and causing progressive kidney function impairment.
Oncology: Typically, a kidney lipoma does not transform into a malignant tumor, but sometimes it's very difficult to distinguish kidney cancer from angiomyolipoma. This is why we approach this diagnosis with concern: there's nothing worse than missing kidney cancer.
These issues prompt us to request: upon hearing from a doctor after an ultrasound "a small benign kidney tumor," please undergo further evaluation. Small tumors grow, large ones cause pain, damage blood vessels, and cause dangerous bleeding, and both can mask malignant tumors.
Usually, patients come to us after a kidney lipoma is detected incidentally on ultrasound or computed tomography (CT), and more often in women than in men, especially during menopause.
Methods of Diagnosis:
How is Angiomyolipoma of the Kidney Treated?
COMPARISON OF OPEN AND LAPAROSCOPIC KIDNEY RESECTION In our practice, angiomyolipoma has never been the reason for kidney removal. When the lipoma reaches large sizes, shows dynamic growth, or examination results indicate a risk of rupture, we perform surgical intervention. In such cases, we always offer laparoscopic surgery – a gentle and minimally invasive procedure.
In this video, the advantages of laparoscopic resection are demonstrated:
- No incision
- No pain
- No risk of inflammation
- No unsightly scar.
Advantages of this Approach:
Our Center has state-of-the-art operating and anesthesia equipment from recognized global leaders in the industry, such as Karl Storz and Olympus. The skill and experience of our specialists, who continuously upgrade their qualifications, enable us to perform kidney resection with consistently successful results and guaranteed avoidance of potential complications.
Our results
How Surgical Treatment Proceeds in Our Clinic:
During
the initial consultation, we assess the results of previous examinations,
perform preliminary analyses, and exclude dangerous conditions such as tuberous
sclerosis. A multidisciplinary team discussion is conducted to decide on the
need for surgery.
CT or MRI of the kidney is
performed at a convenient time for the patient. During this time, we receive
the results of preliminary analyses.
The patient is hospitalized,
and under general anesthesia, minimally invasive laparoscopic resection or
enucleation of the kidney angiomyolipoma is performed.
After
the operation, a medical consultation is held to evaluate the surgical outcomes
and develop individual recommendations for recovery and further preventive
therapy to prevent recurrence.
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