Colović Radoje, Colović Natasa, Grubor Nikica, Radak Vladimir, Micev Marijan, Stojković Mirjana
Srp Arh Celok Lek. 2005 Sep-Oct;133(9-10):433-7. doi: 10.2298/sarh0510433c.
Angiomyolipomas are relatively frequent tumours of the kidney. It is believed that about 10 million people worldwide have such a tumour. About 1/10 of these 10 million are patients who suffer from tuberous sclerosis. The tumours are frequently bilateral, slow growing, and usually asymptomatic, as well as being rare in children. Due to the benign nature of angiomyolipomas, surgical treatment and embolisation of the tumours are generally not recommended, unless renal function is endangered, the symptoms are severe, or the kidney in question becomes completely dysfunctional. This is particularly the case in patients with tuberous sclerosis in whom these tumours are either already bilateral or may become so. We present a 24-year-old woman with tuberous sclerosis in whom bilateral kidney tumours were diagnosed 7 years earlier and in whom we carried out a left nephrectomy of a 5300 gram angiomyolipoma, which caused pain and complete loss of function. Although tumourous, the right kidney was functional, so it was left untouched. After an uneventful recovery, a close follow-up was recommended, as well as HLA typing, as it is highly probable that the right kidney will gradually become inadequate or completely dysfunctional, so that haemodialysis and/or kidney transplantation along with nephrectomy will become necessary.
血管平滑肌脂肪瘤是相对常见的肾脏肿瘤。据信,全球约有1000万人患有这种肿瘤。在这1000万人中,约十分之一是患有结节性硬化症的患者。这些肿瘤通常为双侧性,生长缓慢,通常无症状,在儿童中也较为罕见。由于血管平滑肌脂肪瘤的良性性质,一般不建议对肿瘤进行手术治疗和栓塞,除非肾功能受到威胁、症状严重或相关肾脏完全失去功能。对于患有结节性硬化症的患者尤其如此,在这些患者中,这些肿瘤要么已经是双侧性的,要么可能会变成双侧性。我们报告一名24岁患有结节性硬化症的女性,她在7年前被诊断出患有双侧肾脏肿瘤,我们对其重达5300克、引起疼痛并导致完全功能丧失的左侧血管平滑肌脂肪瘤进行了肾切除术。虽然右侧肾脏有肿瘤,但仍有功能,所以未予处理。在顺利康复后,建议密切随访,并进行HLA分型,因为很有可能右侧肾脏会逐渐功能不全或完全失去功能,届时肾切除术以及血液透析和/或肾脏移植将成为必要。