Assistant Professor of Radiology Department of Radiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Angiomyolipoma (AML) is the most common renal benign tumor. Treatment should be considered for symptomatic patients or for those at risk for complications, especially retroperitoneal bleeding which is correlated to tumor size, grade of the angiogenic component and to the presence of tuberous sclerosis complex (TSC). In addition to size, the presence of intralesional aneurysms should be considered in any prophylactic treatment decision.
Selective arterial embolization (SAE) can be used for prophylaxis of high-risk tumor, for acute management of tumor bleeding, or as a preoperative adjunct treatment for surgery to prevent intraoperative blood loss. The bleeding vessels were selectively catheterized with 4 F or microcatheters and embolized with use of alcohol, PVA, glue or micro coils according to the size of the vessel being embolized. This minimally invasive interventional radiology technique has become the primary treatment for AMLs since several years because it is less invasive than a surgical intervention and enables targeted treatment of bleeding vessels with a low risk of severe complications. SAE is a safe and effective technique to manage renal AMLs as a preventive treatment as well as in emergency setting, with significant reduction in tumor size during follow- up. A multidisciplinary approach remains
fundamental, especially for TSC patients.