Wang Chenyang, Li Xinyuan, Peng Linglong, Gou Xin, Fan Jing
Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, Guangdong Department of Urology, Chongqing Medical University First Affiliated Hospital, Chongqing, China.
Medicine (Baltimore). 2018 Apr;97(16):e0497. doi: 10.1097/MD.0000000000010497.
Renal angiomyolipoma (AML) is a common benign tumor of the kidney. The main complication of AML is retroperitoneal hemorrhage caused by AML rupture, which can be severe and life threatening. The risk of AML rupture used to be determined by tumor size. However, these criteria have been challenged by series of clinical studies and case reports, suggesting prediction AML rupture based on tumor size is not always reliable.
The authors searched PubMed using "angiomyolipoma," "AML," and "rupture" and reviewed relevant studies. The authors investigated the risk factors of AML rupture using the retrieved literature. The authors also summarized current modalities to evaluate and manage AML.
It is established that risk of AML rupture is associated with lesion size. However, genetic abnormality, aneurysm formation, and pregnancy are also risk factors for tumor rupture. Thus, the prediction of AML rupture should be based on a more comprehensive risk assessment system. The management of renal AML and tumor rupture was also discussed in the present paper.
The risk of AML rupture is associated with but not exclusive to lesion size. Any decision to intervene AML must be based on multiple factors including risk, symptoms, and auxiliary findings.
肾血管平滑肌脂肪瘤（AML）是一种常见的肾脏良性肿瘤。AML的主要并发症是AML破裂导致的腹膜后出血，这可能很严重并危及生命。AML破裂的风险过去常由肿瘤大小决定。然而，这些标准受到了一系列临床研究和病例报告的挑战，提示基于肿瘤大小预测AML破裂并不总是可靠的。
作者使用“血管平滑肌脂肪瘤”“AML”和“破裂”在PubMed上进行检索并回顾相关研究。作者利用检索到的文献研究AML破裂的危险因素。作者还总结了当前评估和处理AML的方式。
已确定AML破裂风险与病变大小相关。然而，基因异常、动脉瘤形成和妊娠也是肿瘤破裂的危险因素。因此，AML破裂的预测应基于更全面的风险评估系统。本文还讨论了肾AML及肿瘤破裂的处理。
AML破裂风险与病变大小相关，但并非仅取决于病变大小。任何干预AML的决定都必须基于包括风险、症状和辅助检查结果在内的多个因素。
