Angioembolization followed by nephrectomy for giant renal angiomyolipoma in a 30-year-old woman: a case report
DOI:
https://doi.org/10.13181/mji.cr.268210Keywords:
angiomyolipoma, nephrectomy, womenAbstract
Renal angiomyolipoma (AML) is a benign renal tumor that can grow significantly and cause complications, such as hemorrhage and pain, necessitating active intervention. Managing giant AML in young women remains challenging, and evidence for multimodal approaches is limited. This case report describes the management of a giant AML by selective renal angioembolization (RAE) followed by total nephrectomy. A 30-year-old woman presented with an 18 × 20 × 22 cm AML, resulting in bleeding and kidney dysfunction. Total nephrectomy was performed after stabilization with RAE. This multimodal approach reduces surgical risk and preserves renal function. Combining RAE with nephrectomy shows promise for treating complex giant AML and warrants further research to optimize the technique and assess the long-term outcomes.
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Al-Hajjaj M. Giant renal angiomyolipoma: a case report. Urol Case Rep. 2021;38:101736. https://doi.org/10.1016/j.eucr.2021.101736
Gora BS, Singh S, Babu A, Lakhera KK, Patel P, Singhal PM, et al. Giant renal angiomyolipoma: a rare and formidable challenge: a case report. Indian J Surg Oncol. 2024;15(Suppl 3):456-9. https://doi.org/10.1007/s13193-024-02035-4
Combes A, McQueen S, Palma CA, Benz D, Leslie S, Sved P, et al. Is size all that matters? New predictors of complications and bleeding in renal angiomyolipoma. Res Rep Urol. 2023;15:113-21. https://doi.org/10.2147/RRU.S400730
Restrepo JC, Millan DA, Sabogal CA, Bernal AF, Donoso WD. New trends and evidence for the management of renal angiomyolipoma: a comprehensive narrative review of the literature. J Kidney Cancer VHL. 2022;9(1):33-41. https://doi.org/10.15586/jkcvhl.v9i1.177
Fernández-Pello S, Hora M, Kuusk T, Tahbaz R, Dabestani S, Abu-Ghanem Y, et al. 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. Eur Urol Oncol. 2020;3(1):57-72. https://doi.org/10.1016/j.euo.2019.04.005
Ahmadov J, Çay F, Eldem G, Akdoğan B, Bilen CY, Aki FT, et al. Endovascular management of renal angiomyolipomas: do coils have a benefit in terms of clinical success rates? Diagn Interv Radiol. 2022;28(6):597-602. https://doi.org/10.5152/dir.2022.201044
Koesbandono, Sidipratomo P, Utomo R, Tansol C, Kurniawan YC. Transarterial embolization in Wunderlich syndrome due to recanalization of giant renal angiomyolipoma pseudoaneurysm: a case report and literature review. Egypt J Radiol Nucl Med. 2024;55(132). https://doi.org/10.1186/s43055-024-01301-3
Bouaziz H, Ghalleb M, Tounsi N, Riahi N, Bouzaiene H, Ziadi J, et al. A renal angiomyolipoma with a challenging presentation: a case report. J Med Case Rep. 2021;15(1):477. https://doi.org/10.1186/s13256-021-03073-0
Prasad SR, Surabhi VR, Menias CO, Raut AA, Chintapalli KN. Benign renal neoplasms in adults: cross-sectional imaging findings. AJR Am J Roentgenol. 2008;190(1):158-64. https://doi.org/10.2214/AJR.07.2724
Abdessater M, El Khoury J, Kanbar A, Kheir P. Renal angiomyolipomas with inferior vena cava invasion. SN Compr Clin Med. 2020;2:2870-82. https://doi.org/10.1007/s42399-020-00630-4
Gaffoor N, Mysorekar VV, Gunadal S, Divyashree BN, Sandeepa S, Murali N. Wunderlich syndrome: a rare case associated with bleeding renal angiomyolipoma (AML). Indian J Nephrol. 2024;34(3):271-3. https://doi.org/10.4103/ijn.ijn_397_23
Gürsoy D, Seçinti İE, Hakverdi S, Görür S. Renal angiomyolipoma: a clinicopathological study of seven cases and review of the literature. Bull Urooncol. 2020;19(3):118-23. https://doi.org/10.4274/uob.galenos.2020.1438
Vos N, Oyen R. Renal angiomyolipoma: the good, the bad, and the ugly. J Belg Soc Radiol. 2018;102(1):41. https://doi.org/10.5334/jbsr.1536
Tsauo J. Embolization coils: materials, designs, and future directions. International J Gastrointest Interv. 2025;14(3):93-7. https://doi.org/10.18528/ijgii250044
Jin L, Chun HJ, Oh JS, Choi BG, Lee HG, Kim IJ. Selective arterial embolization of renal angiomyolipoma: comparing ethanol-lipiodol emulsion and polyvinyl alcohol particles as embolic agents. Diagn Interv Radiol. 2023;29(1):170-4. https://doi.org/10.5152/dir.2022.21625
Ding BT, Decruz J, Kunnasegaran R. Time-sensitive ambulatory orthopaedic soft-tissue surgery paradigms during the COVID-19 pandemic. Int Orthop. 2020;44:1531-8. https://doi.org/10.1007/s00264-020-04606-w
Lin L, Li X, Guan H, Wang J, Tong X, Yang M, et al. Renal function, complications, and outcomes of a reduction in tumor size after transarterial embolization for renal angiomyolipomas: a meta-analysis. J Int Med Res. 2019;47(4):1417-28. https://doi.org/10.1177/0300060519834447
Bardin F, Chevallier O, Bertaut A, Delorme E, Moulin M, Pottecher P, et al. Selective arterial embolization of symptomatic and asymptomatic renal angiomyolipomas: a retrospective study of safety, outcomes and tumor size reduction. Quant Imaging Med Surg. 2017;7(1):8-23. https://doi.org/10.21037/qims.2017.01.02
Swärd J, Bohlin K, Henrikson O, Lundstam S, Peeker R, Grenabo Bergdahl A. Long-term efficacy of selective arterial embolisation of renal angiomyolipoma. Scand J Urol. 2023;58:86-92. https://doi.org/10.2340/sju.v58.12318
Jung Y, Choi MJ, Kim BM, Kim YM, Seo Y. Transarterial embolization for sporadic renal angiomyolipoma: patient selection and technical considerations for optimal therapeutic outcomes. Taehan Yongsang Uihakhoe Chi. 2022;83(3):559-81. https://doi.org/10.3348/jksr.2021.0120
Pericas R, Liou C, Aberle D, Gorroochurn P, Anderson CB. Rates of volume reduction after selective arterial embolization for renal angiomyolipoma. Urol Oncol. 2025;43(11):662.e17-23. https://doi.org/10.1016/j.urolonc.2025.06.021
Perdana NR, Daulay ER, Prapiska FF. Renal arteries embolization in unresectable clear cell renal carcinoma: first time experience at Haji Adam Malik Hospital. Open Access Maced J Med Sci. 2018;6(8):1454-7. https://doi.org/10.3889/oamjms.2018.282
Para SA, Mehdi S, Malik S, Wani S, Bhat A, Choh N, et al. Safety and efficacy of selective renal artery embolization in the management of postprocedural acute renal bleeding: experience of a tertiary care center. J Urol Surg. 2023;10(4):326-33. https://doi.org/10.4274/jus.galenos.2023.2022.0097
Oesterling JE, Fishman EK, Goldman SM, Marshall FF. The management of renal angiomyolipoma. J Urol. 1986;135(6):1121-4. https://doi.org/10.1016/S0022-5347(17)46013-7
Cochetti G, Zingaro MD, Boni A, Allegritti M, de Vermandois JA, Paladini A, et al. Renal artery embolization before radical nephrectomy for complex renal tumour: which are the true advantages? Open Med (Wars). 2019;14:797-804. https://doi.org/10.1515/med-2019-0095
Alshehri M, Hakami B, Aljameel N, Alayyaf M, Raheem AA. Sporadic giant renal angiomyolipoma: a case report and literature review of clinical presentation, diagnosis, and treatment options. Urol Ann. 2020;12(2):167-71. https://doi.org/10.4103/UA.UA_26_19
Bréhier G, Bouvier A, Besnier L, Willoteaux S, Nedelcu C, Culty T, et al. Renal function after partial nephrectomy following intra-arterial embolization of renal tumors. Sci Rep. 2020;10:21352. https://doi.org/10.1038/s41598-020-78461-5
Kumar GA, Prasad PV, Kumar AR, Sindhuri A, Babu BS. Giant renal angiomyolipoma managed by selective renal angioembolization: a unique case report. J Sci Soc. 2020;47(2):126. https://doi.org/10.4103/jss.JSS_27_20
Nebioğlu A, Doruk HE, Gökalp Satıcı FE, Yuyucu Karabulut Y, Özer C. Treatment of recurrent giant angiomyolipoma after nephrectomy with selective arterial embolization: a case report. J Urol Surg. 2024;11(2):129-33. https://doi.org/10.4274/jus.galenos.2023.2023-7-5
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