The pre-operative diagnosis of renal hamartoma

Treatment of arteriovenous angiomas of the kidney: surgical intervention and intra-arterial embolization

Angiomas of the kidney are benign vascular dysplasias, which usually can be identified angiographically. If there are no clinical symptoms treatment is not necessary. In cases of hematuria and/or hypertension either intra-arterial superselective embolization seems to cause less functional loss of the renal parenchyma, whereas excision often leads to heminephrectomy or even total nephrectomy. Even if the angioma is initially not completely embolized followup study to 2 years has shown complete occlusion of the angioma, either owing to inflammatory reactions or redistribution of blood flow and diminished blood pressure. Two cases of renal angiomas are presented. Treatment consisted of intra-arterial superselective embolization in 1 case and surgical clipping of the supplying arterial branch in the other.

Rupture of a renal angiomyolipoma (hamartoma)

A 54-year-old woman with spontaneous rupture of angiomyolipoma is presented. The literature on the 2 types of angiomyolipoma, without and with association of tuberose sclerosis, their rarity and the difficulties in their diagnoses, is reviewed.

Angiographic manifestations of renal hamartoma

Two types of renal hamartoma (angiomyolipoma) are presented with emphasis on angiographic findings. Careful analysis of the angiograms can suggest a specific diagnosis. Two important considerations other than angiographic findings are (1) multiplicity of tumors in patients with tuberous sclerosis, and (2) a solitary mass in 40-60-year-old women.