A Case of Life-threatening Rupture of Small Renal Angiomyolipoma with an Unidentified Intratumoral Aneurysm during Follow-up.

Interventional radiology (Higashimatsuyama-shi (Japan) Pub Date : 2024-02-08 eCollection Date: 2024-03-01 DOI:10.22575/interventionalradiology.2023-0013

Masashi Tajiri, Tomoyuki Gentsu, Masato Yamaguchi, Koji Sasaki, Eisuke Ueshima, Takuya Okada, Koji Sugimoto, Takamichi Murakami

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Abstract

We report a case of a life-threatening ruptured renal angiomyolipoma (AML) that did not meet the criteria for prophylactic treatment (tumor >4 cm or intratumoral aneurysm >5 mm) during follow-up. A woman in her 70s was followed up for a 2.5-cm AML with a rich vascular component. An intratumoral aneurysm >5 mm was not identified for 2 years. She complained of a sudden abdominal pain with hypotension, and contrast-enhanced computed tomography revealed a retroperitoneal hematoma with contrast media extravasation from an intratumoral aneurysm. Emergency transcatheter arterial embolization was successfully performed using N-butyl cyanoacrylate glue. Rupture can occur in small AMLs or in AMLs not identified with intratumoral aneurysms during follow-up. AMLs with a rich vascular component at the kidney surface are more likely to rupture.

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一例在随访过程中发现不明瘤内动脉瘤的小型肾血管瘤破裂，危及生命。

我们报告了一例危及生命的肾血管肌脂肪瘤（AML）破裂病例，该病例在随访期间未达到预防性治疗的标准（肿瘤大于 4 厘米或瘤内动脉瘤大于 5 毫米）。一名 70 多岁的妇女因 2.5 厘米、血管成分丰富的 AML 接受随访。2 年来，她一直没有发现直径大于 5 毫米的瘤内动脉瘤。她主诉突然腹痛并伴有低血压，造影剂增强计算机断层扫描显示腹膜后血肿，造影剂从瘤内动脉瘤外渗。使用氰基丙烯酸正丁酯胶水成功进行了紧急经导管动脉栓塞术。小的急性髓细胞癌或在随访过程中未发现有瘤内动脉瘤的急性髓细胞癌也可能发生破裂。肾脏表面血管成分丰富的急性髓系白血病更容易破裂。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Interventional radiology (Higashimatsuyama-shi (Japan)

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