Successful treatment of a patient with renal angiomyolipomas with intratumoral hemorrhage

Military Hospital 175 has just successfully treated patient HTD (46 years old) with renal angiomyolipomas with hemorrhage in the tumor.

A year ago, during a medical examination, the patient discovered a 2cm renal angiolipoma in the upper pole of the right kidney. The patient was regularly monitored locally because the tumor did not cause any symptoms. In the past 6 months, the size of the lipomyoma increased rapidly, reaching nearly 8cm, and the patient was transferred to Military Hospital 175 for treatment.

The patient went to the Department of Urology for examination. A 32-slice abdominal CT scan with contrast showed: a mass in the upper pole of the right kidney measuring 80x62x55mm, with relatively clear boundaries, mixed density, containing macroscopic fat, with a solid component that strongly absorbed the contrast after injection.

After multidisciplinary consultation, the patient was admitted to the Department of Gastroenterology for transarterial tumor embolization. The patient was treated with endovascular intervention under the guidance of digital subtraction angiography (DSA). After 30 minutes of the procedure, the patient's condition was stable, discharged after 1 day and scheduled for a follow-up visit after 3 months.

Dr. Nguyen The Dung, Department of Internal Medicine and Gastroenterology, Military Hospital 175, who directly performed the intervention procedure, said that technically the intervention was successful when it completely blocked the bleeding branch of the tumor, preventing complications of tumor rupture while preserving the renal branch of the tumor. In the long term, the tumor will gradually shrink due to the lack of blood supply.

Dr. Dung said that many studies in the world show that tumors can reduce in size from 30-50% compared to the time before the embolization in the first year. Some tumors can increase in size after a few years and need to continue embolization intervention.

Renal angiomyolipomas are benign tumors in the kidney, diagnosis is often based on CT images of the urinary system. If diagnosed with renal angiomyolipomas, we should periodically check and monitor the progression of the disease. With tumors larger than 4cm causing compression and symptoms, you need to be advised on preventive treatment for tumor rupture. Among current AML treatment methods, transarterial embolization (TAE) is a priority method because the procedure is minimally invasive, highly effective, and preserves the kidney compared to surgical removal of the tumor - Dr. Dung further recommended.

Renal Angiomyolipomas (AML) are benign tumors of the kidney composed of fat, smooth muscle, and blood vessels. They are common in women over 50 years old and are associated with tuberous sclerosis. AML is often discovered incidentally during a physical examination, progresses slowly, and causes almost no symptoms in patients.

Some AMLs that increase in size can cause some symptoms such as anemia, pain in the lumbar region, hematuria, kidney failure... More dangerously, if the AML mass ruptures, it can cause complications such as rapidly progressing retroperitoneal bleeding, life-threatening hemorrhagic shock, requiring surgical treatment to remove the kidney.

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