Gallmetzer J, Gozzi C, Ortore P, Salsa A, Dolif R, Bonatti G
Ospedale Provinciale di Bressanone, Italia.
Arch Ital Urol Androl. 1999 Feb;71(1):47-51.
Renal angiomyolipoma is an uncommon benign tumor composed of adipose tissue, dysplastic blood vessels and smooth muscle. The tumor may occur as a distinct entity or in association with tuberous sclerosis. The diagnosis is usually easy but a malignant neoplasm can not always be excluded. Tumors smaller than 4 cm are mostly asymptomatic and usually do not need to be treated. For larger lesions a treatment is advisable especially in case of symptoms because of the risk of a severe hemorrhage. The treatment should be as conservative as possible and nephrectomy preformed only when a malignant tumor can not be excluded or in cases of life-threatening hemorrhage or widespread infiltration or complete destruction of the kidney. Today the treatment of choice should be embolisation and on second line resection of the lesion. Two cases of symptomatic angiomyolipoma are presented. Both cases are treated by radical nephrectomy.
肾血管平滑肌脂肪瘤是一种由脂肪组织、发育异常的血管和平滑肌组成的罕见良性肿瘤。该肿瘤可单独出现或与结节性硬化症相关。诊断通常容易,但并非总能排除恶性肿瘤。小于4厘米的肿瘤大多无症状,通常无需治疗。对于较大的病变,尤其是出现症状时,由于有严重出血的风险,建议进行治疗。治疗应尽可能保守,仅在不能排除恶性肿瘤或出现危及生命的出血、广泛浸润或肾脏完全破坏的情况下才进行肾切除术。如今,首选的治疗方法应该是栓塞,二线治疗是病变切除术。本文介绍了两例有症状的血管平滑肌脂肪瘤病例。两例均行根治性肾切除术。