Gould Rothberg Bonnie E, Grooms Mary C, Dharnidharka Vikas R
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA.
Obstet Gynecol. 2006 Sep;108(3 Pt 2):734-6. doi: 10.1097/01.AOG.0000188062.13749.ef.
Kidney angiomyolipomas are benign but progressive tumors consisting of smooth muscle, fat, and vascular elements, commonly associated with the tuberous sclerosis complex. Angiomyolipomas express estrogen and progesterone receptors and have been reported to increase in size in pregnancy.
A 15-year-old girl with stable angiomyolipomas of tuberous sclerosis complex was treated for menorrhagia with estrogen/progestin oral contraceptive pills. During the 12 months of contraceptive therapy, a new 4-cm exophytic angiomyolipoma developed that required selective arterial embolization to reduce its risk of spontaneous rupture.
Treating menorrhagia with exogenous hormonal therapy in women with tuberous sclerosis complex should be accompanied by regular renal imaging to reduce the risk of an unanticipated angiomyolipoma-related adverse event. Alternate nonhormonal therapies for menorrhagia may also be considered.
肾血管平滑肌脂肪瘤是由平滑肌、脂肪和血管成分组成的良性但呈进行性生长的肿瘤，通常与结节性硬化症相关。血管平滑肌脂肪瘤表达雌激素和孕激素受体，并且有报道称其在妊娠期会增大。
一名患有结节性硬化症且血管平滑肌脂肪瘤病情稳定的15岁女孩，因月经过多接受雌激素/孕激素口服避孕药治疗。在12个月的避孕治疗期间，出现了一个新的4厘米外生性血管平滑肌脂肪瘤，需要进行选择性动脉栓塞以降低其自发破裂的风险。
对于患有结节性硬化症的女性，在外源性激素治疗月经过多时，应定期进行肾脏影像学检查，以降低与血管平滑肌脂肪瘤相关的意外不良事件的风险。也可考虑月经过多的其他非激素治疗方法。
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