Department of Urology, Inagi Municipal Hospital, 1171 Omaru, Inagi, Tokyo, Japan.
Clin Exp Nephrol. 2011 Dec;15(6):953-6. doi: 10.1007/s10157-011-0519-9. Epub 2011 Aug 17.
The case of a 63-year-old woman with a relatively rapidly growing angiomyolipoma (AML) originating from the right renal sinus is presented. The tumor had enlarged to more than fivefold in volume (7.4 × 6.7 × 10.1 cm) in the 7 years following its detection (5.6 × 3.4 × 4.6 cm) and had significantly pushed aside the duodenum and the inferior vena cava. The tumor was surgically resected together with the right kidney, and pathological examination revealed AML originating from the renal sinus. An AML involving or originating from the renal sinus is exceedingly rare; only 14 cases have been reported. Rapidly growing AMLs of the renal sinus are difficult to differentiate from liposarcoma because of similar findings in imaging studies. It should be noted that AML of the renal sinus can be a differential diagnosis of retroperitoneal fatty mass. Furthermore, an enlarged AML in the renal sinus may push aside other organs, such as the ileum, pancreas, and major vessels. Clinicians should determine whether these patients should be placed under active surveillance or be treated with invasive measures, such as radical nephrectomy.
本文报告了一例源自右肾窦的生长相对较快的血管平滑肌脂肪瘤(AML)的 63 岁女性病例。自发现以来(5.6×3.4×4.6cm),肿瘤体积已增至原来的五倍以上(7.4×6.7×10.1cm),并显著推挤了十二指肠和下腔静脉。肿瘤连同右肾一起被手术切除,病理检查显示源自肾窦的 AML。起源于肾窦的 AML 非常罕见;仅报告了 14 例。由于影像学检查结果相似,生长迅速的肾窦 AML 很难与脂肪肉瘤相鉴别。值得注意的是,肾窦的 AML 可以作为腹膜后脂肪肿块的鉴别诊断。此外,肾窦内增大的 AML 可能会推挤其他器官,如回肠、胰腺和大血管。临床医生应确定这些患者是否应接受积极监测或采用侵入性治疗,如根治性肾切除术。