Jawahar Anugayathri, Kazan-Tannus Joao
Department of Radiology, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Urol Ann. 2017 Jul-Sep;9(3):288-292. doi: 10.4103/UA.UA_20_17.
Retroperitoneal extrarenal angiomyolipoma (RERAML) are rare and close mimickers of retroperitoneal liposarcoma on both imaging and histopathology. However, imaging findings including heterogeneity, hyperdensity on unenhanced computed tomography, intralesional hemorrhage, absence of calcifications, low signal intensity on T2-weighted magnetic resonance imaging, and dilated intratumoral vessels can lead to the diagnosis of RERAML. Diagnosis of RERAML can avoid unnecessary surgery since conservative medical management with continued surveillance has been proven to be effective for RERAML whereas surgical resection is the treatment for liposarcoma. Imaging and laboratory follow-up for at least 5 years has been recommended in patients who underwent surgical resection of angiomyolipoma (AML). We present a case of RERAML in an asymptomatic patient whose AML recurred in the surgical bed 8 years after an ipsilateral nephrectomy for renal AML.
腹膜后肾外血管平滑肌脂肪瘤（RERAML）罕见，在影像学和组织病理学上都与腹膜后脂肪肉瘤极为相似。然而，包括密度不均匀、未增强计算机断层扫描上的高密度、瘤内出血、无钙化、T2加权磁共振成像上的低信号强度以及瘤内血管扩张等影像学表现可有助于RERAML的诊断。RERAML的诊断可避免不必要的手术，因为已证实对RERAML采用持续监测的保守药物治疗是有效的，而脂肪肉瘤的治疗方法是手术切除。对于接受血管平滑肌脂肪瘤（AML）手术切除的患者，建议进行至少5年的影像学和实验室随访。我们报告一例无症状患者的RERAML病例，该患者在因肾AML行同侧肾切除术后8年，AML在手术床复发。
