Koh Joo-Lee, Lee Ying-Huei, Kang Chieh-Yi, Lin Ching-Nan
Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan, ROC.
J Reprod Med. 2007 Apr;52(4):338-40.
Renal angiomyolipoma with spontaneous bleeding during pregnancy is an extremely rare condition and may jeopardize both the mother and fetus. The ethics of reproductive medicine, method of diagnosis, option for management and optimal time for surgical intervention can be arguable in this situation.
A 31-year-old woman presented with dull right flank pain at 12 weeks' gestation. Abdominal sonography and renal magnetic resonance imaging revealed a hypervascular and fat-containing mass with mother and fetus bleeding at the right kidney. Due to stable hemodynamic status, the patient was treated conservatively and underwent elective, simultaneous cesarean section and radical nephrectomy safely at 38 weeks' gestation. Angiomyolipoma of the right kidney was diagnosed on pathologic examination.
Renal angiomyolipoma with spontaneous bleeding during pregnancy is a dangerous condition that may cause mortality in the mother and fetus, but elective, simultaneous cesarean section and radical nephrectomy can be performed safely if the hemodynamic status is stable.
妊娠期肾血管平滑肌脂肪瘤伴自发性出血是一种极为罕见的情况，可能危及母亲和胎儿。在这种情况下，生殖医学伦理、诊断方法、治疗选择及手术干预的最佳时机都可能存在争议。
一名31岁女性在妊娠12周时出现右侧腰部隐痛。腹部超声和肾脏磁共振成像显示右肾有一个富含血管和脂肪的肿块，且伴有母亲和胎儿出血。由于血流动力学状态稳定，患者接受了保守治疗，并在妊娠38周时安全地接受了择期剖宫产和根治性肾切除术。病理检查确诊为右肾血管平滑肌脂肪瘤。
妊娠期肾血管平滑肌脂肪瘤伴自发性出血是一种危险情况，可能导致母亲和胎儿死亡，但如果血流动力学状态稳定，择期剖宫产和根治性肾切除术可安全进行。
