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肾症状性血管平滑肌脂肪瘤的不同治疗方法:两例报告

Different Treatments of Symptomatic Angiomyolipomas of the Kidney: Two Case Reports.

作者信息

Pacella Giuseppina, Faiella Eliodoro, Altomare Carlo, Andresciani Flavio, Castiello Gennaro, Bernetti Caterina, Sarli Marina, Zobel Bruno Beomonte, Grasso Rosario Francesco

机构信息

Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.

出版信息

J Kidney Cancer VHL. 2021 Oct 19;8(4):32-37. doi: 10.15586/jkcvhl.v8i4.181. eCollection 2021.

Abstract

Development of more sensitive imaging techniques has caused an increase in the number of diagnosed small renal tumors. Approximately 2-3% of these lesions are proved to be angiomyolipomas (AML), a rare benign tumor of the kidney sometimes causing pain and hematuria. The most required approach is observation, but in the case of recurrent symptoms or larger tumors, which may cause bleeding, a more active treatment is required. We present two cases of symptomatic AML tumors of different sizes in the kidney: one treated with transarterial embolization (TAE), and the other with percutaneous cryoablation (CRA). The lesions were diagnosed on the basis of contrast-enhanced computed tomography (CT) scan and magnetic resonance imaging (MRI). Both treatments proved to be effective and safe for treating renal AMLs. A follow-up carried out, based on contrast-enhanced CT scan, confirmed complete treatment of AML and decreased lesion size. There are myriad minimally invasive approaches for the treatment of renal AMLs, and the preservation of renal function remains a priority. The most popular treatment option is the selective renal artery embolization. Owing to its limited invasiveness, CRA could be an attractive option for the preventive treatment of AML.

摘要

更灵敏成像技术的发展导致了诊断出的小肾肿瘤数量增加。这些病变中约2%-3%被证实为肾血管平滑肌脂肪瘤(AML),这是一种罕见的肾脏良性肿瘤,有时会引起疼痛和血尿。最常用的方法是观察,但对于复发性症状或较大肿瘤(可能导致出血)的情况,则需要更积极的治疗。我们展示了两例肾脏中不同大小的有症状AML肿瘤病例:一例采用经动脉栓塞术(TAE)治疗,另一例采用经皮冷冻消融术(CRA)治疗。病变通过对比增强计算机断层扫描(CT)和磁共振成像(MRI)诊断。两种治疗方法对治疗肾AML均被证明是有效且安全的。基于对比增强CT扫描进行的随访证实了AML的完全治疗且病变大小减小。对于肾AML的治疗有多种微创方法,保留肾功能仍然是首要任务。最常用的治疗选择是选择性肾动脉栓塞术。由于其侵入性有限,CRA可能是AML预防性治疗的一个有吸引力的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3016/8532053/5c27004452f9/JKCVHL-8-032-g001.jpg

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