Renal angiomas

Diagnosis and Management of Renal Angioma

Five patients with symptomatic renal angiomata are described. All presented with heavy haematuria and unilateral ureteric obstruction without evidence of a mass distorting the renal architecture. Renal angiomata are most easily diagnosed by selective renal angiography. They may be treated by intra-arterial embolization, avoiding the need for major ablative surgery.

Partial Nephrectomy for Renal Haemangioma

Three cases of renal haemangioma presenting with haematuria are reported. Each was investigated by angiography and treated successfully by partial nephrectomy.

Pericaliceal haemangioma-a cause of papillary necrosis? Case report and review of 7 similar vascular lesions

A pericaliceal haemangioma associated with papillary necrosis caused haematuria which led to nephrectomy. Seven similar vascular lesions were found on review of the surgical histopathology records from the last 25 years at the St Peter's Hospitals, Institute of Urology, London. In 4 of these there was histological evidence of damage to the renal papilla adjacent to the vascular abnormality; a possible mechanism for these changes is discussed. In all 8 cases the patients presented with haematuria and, in 5, abnormalities were seen on renal radiological investigation. Nephrectomy was performed in 5 instances and the remaining 3 patients were treated by partial nephrectomy. The presence of a vascular malformation was considered pre-operatively in 2 patients and in the remainder the diagnosis was first made on laboratory examination. In all patients haematuria ceased post-operatively and in 5 cases where follow-up information was available there has been no evidence of bilateral involvement.

Renal hemangioma: cause of massive hematuria

Renal hemangiomas are an unusual cause of renal hematuria. Although a preoperative diagnosis of renal hemangioma is not always possible, the diagnosis of this case of marked blood loss from a renal hemangioma was made angiographically. The clinical characteristics of hemangiomas, as well as the use of angiography in the investigation of hematuria, are discussed.

Roentgenologic aspects of haematuria

In the roentgenologic investigation of haematuria, urography is the main diagnostic tool, other examinations being only of supplementary value. The main importance of other roentgen examinations is the possibility of excluding certain types of suspected disease as the cause of haematuria, and to demonstrate certain vascular malformations in the kidneys with renal angiography. Urography and cystoscopy should be performed in all patients with haematuria, and the possibility of pathologic conditions in both upper and lower urinary tract must be kept in mind. A large number of overlooked calculi and the finding of unsuspected malignant renal tumors in cases where the urography was performed on an emergency basis, underlines the important fact that "emergency" in these cases only indicates that the patient is an acute distress, not that the examination should be hasty and incomplete, or if so, should be supplemented by a repeat examination under normal conditions.