Fujiwara Motohiro, Kawamura Naoko, Okuno Tetsuo
Department of Urology, JA Toride Medical Center, Japan.
J Rural Med. 2018 Nov;13(2):181-184. doi: 10.2185/jrm.2976. Epub 2018 Nov 29.
Renal angiomyolipoma without local invasion is usually considered benign entity, however, it may extend into the renal vein or the inferior vena cava. Renal angiomyolipoma with venous extension should be treated; however, surgical complications such as iatrogenic pulmonary fat embolism remain a serious concern. We present a case of a 66-year-old Japanese woman without tuberous sclerosis in whom a right-sided renal tumor was incidentally detected on ultrasonography during a health check-up. Further evaluation showed that the tumor extended into the renal vein, and she was successfully treated using preoperative inferior vena cava filter placement and radical nephrectomy. An inferior vena cava filter can prevent catastrophic pulmonary fat embolism during nephrectomy.
无局部浸润的肾血管平滑肌脂肪瘤通常被视为良性病变，然而，它可能延伸至肾静脉或下腔静脉。伴有静脉延伸的肾血管平滑肌脂肪瘤应予治疗；然而，诸如医源性肺脂肪栓塞等手术并发症仍是一个严重问题。我们报告一例66岁无结节性硬化症的日本女性病例，该患者在健康体检时经超声偶然发现右侧肾肿瘤。进一步评估显示肿瘤延伸至肾静脉，通过术前放置下腔静脉滤器及根治性肾切除术，她获得了成功治疗。下腔静脉滤器可预防肾切除术中发生灾难性肺脂肪栓塞。
