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Emam F, Hammoud R, Twair A, Mukhtar Hussein ML. Bilateral renal angiomyolipoma with venous invasion: A case report. Radiol Case Rep 2024; 19:3191-3194. [PMID: 38800084 PMCID: PMC11126760 DOI: 10.1016/j.radcr.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/30/2024] [Accepted: 04/01/2024] [Indexed: 05/29/2024] Open
Abstract
Renal angiomyolipoma (AML) is a rare benign tumor of the kidney, often detected incidentally on radiological images as the presence of macroscopic fat characterizes them. In the majority of the cases, they are usually sporadic. Despite their benign nature, venous invasion, a rare occurrence in renal AMLs, poses management challenges. We present a case of bilateral renal AML in a 52-year-old female with a right renal vein and hepatic inferior vena cava invasion.
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Affiliation(s)
- Fatima Emam
- Radiology Department, Hamad general hospital, Hamad medical corporation (HMC), Doha Qatar
| | - Rani Hammoud
- Otolaryngology Department, Hamad general hospital, Hamad medical corporation (HMC), Doha Qatar
| | - Akram Twair
- Radiology Department, Hamad general hospital, Hamad medical corporation (HMC), Doha Qatar
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Thakur B, Hiwale KM. Intricacy in the Diagnosis of Retroperitoneal Angiomyolipoma: A Rare Case. Cureus 2023; 15:e36357. [PMID: 37082478 PMCID: PMC10112489 DOI: 10.7759/cureus.36357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/19/2023] [Indexed: 04/22/2023] Open
Abstract
An uncommon benign mixed mesenchymal tumor called extrarenal retroperitoneal angiomyolipoma (ERAML) comprises thick-walled blood vessels, smooth muscle cells, and mature fat cells. Angiomyolipoma often develops in the kidneys, with extrarenal locations being uncommon. Many angiomyolipomas are unintentionally discovered when a person undergoes other medical issues. A 35-year-old man presented with a history of difficulty breathing and was on antibiotics. On follow-up, CT revealed a 22.5 × 14.3 × 8.6 cm right retroperitoneal mass. The retroperitoneal mass was resected en bloc at laparotomy and sent for histopathological examination. The grossly resected specimen was a smooth, well-circumscribed, yellowish-red retroperitoneal mass measuring 23 × 15 × 9 cm. The microscopic section reveals a tumor with prominent blood vessels and fatty tissue composed of spindle cells arranged into fascicles. The final diagnosis for this case is ERAML, which was challenging to distinguish from liposarcoma.
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Affiliation(s)
- Bharati Thakur
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - K M Hiwale
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Mohammadzadeh N, Kohansal S, ghasemlouei A. Recurrent retroperitoneal extra-renal angiomyolipoma: A case report and review of literature. Ann Med Surg (Lond) 2022; 81:104230. [PMID: 36147106 PMCID: PMC9486440 DOI: 10.1016/j.amsu.2022.104230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 01/10/2023] Open
Abstract
Introduction Angiomyolipoma (AML) is the most prevalent renal mesenchymal neoplasm that almost always involves kidneys. Case presentation We present a rare condition of retroperitoneal extra-renal angiomyolipoma which relapsed after 4 years that caused acute abdominal pain. Discussion The liver is the most common site of extrarenal angiomyolipoma. Abdominal pain is the most common complaint of extra-renal angiomyolipoma. Computed tomography angiography is the best way for angiomyolipoma diagnosis and surgery and post-surgery chemotherapy is the way for its treatment. Conclusion extrarenal angiomyolipoma is an extremely rare condition that patients should be followed up for over 5 years by appropriate radiologic imaging. Angiomyolipoma almost always involves kidneys. We present a retroperitoneal extra-renal angiomyolipoma case.
extra-renal angiomyolipoma is characterized as a benign tumor. We present a recurrent retroperitoneal extra-renal angiomyolipoma.
surgery is one of the best ways to both diagnosis and treatment of retroperitoneal extra-renal angiomyolipoma.
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Affiliation(s)
- Narjes Mohammadzadeh
- Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir ghasemlouei
- Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author.
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Sato K, Saijo F, Katayose Y, Mutoh M, Iwama N, Nakayama F, Tokumura H. Surgical resection of extremely rare primary giant splenic angiomyolipoma: a case report. Surg Case Rep 2021; 7:110. [PMID: 33939051 PMCID: PMC8093371 DOI: 10.1186/s40792-021-01192-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/28/2021] [Indexed: 11/25/2022] Open
Abstract
Background Angiomyolipoma is a benign mesenchymal tumor that develops commonly in the kidney and rarely in other organs. The involvement of the spleen in angiomyolipoma is extremely rare, and only one such case has been reported in the English literature.
Case presentation A 27-year-old man presented with adenoid hyperplasia and bilateral palatal tonsillar hyperplasia. During the treatment for adenoid hyperplasia, a 15-cm tumor was detected in the spleen using abdominal ultrasonography and enhanced computed tomography. Partial resection of the spleen was successfully performed. A giant tumor of approximately 13 cm with a smooth surface was observed in the upper left quadrant of the abdomen. The tumor was confirmed to be continuous with the upper spleen, and there was no invasion of the other organs. The postoperative course was good, and the patient was discharged on the 7th postoperative day. The excised specimen was a smooth, extremely soft tumor measuring 123 × 120 × 82 mm. The cleaved surface of the tumor was reddish brown, and a distressing yellow color was observed. Pathological examination revealed a proliferation of mature adipocytes and an increase in the number of blood vessels of various sizes. Furthermore, spindle-shaped cell proliferation foci were visible between the adipocytes and the surrounding blood vessels. Profuse leakage of erythrocytes from the blood vessels, hemosiderin deposition, and small round cell infiltration were also noted. Immunostaining disclosed that the spindle-shaped cells were weakly positive for smooth muscle antibody and were identified as smooth muscle cells. The adipocytes and spindle cells were negative for HMB 45, Melan A, MDM, and CDK4. However, some parts of the cells were positive for estrogen and progesterone receptors. Besides, vascular endothelial cells were positive for CD31 and CD34 and negative for CD8. Based on these findings, the patient was diagnosed to have primary angiomyolipoma of the spleen. Conclusions We have reported the surgical treatment for an extremely rare case of giant splenic angiomyolipoma in a young man. Globally, this is the second report on this condition. We believe that partial splenic resection is a feasible option for the management of giant tumors.
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Affiliation(s)
- Kaoru Sato
- Department of Surgery, Tohoku Rosai Hospital, 4-3-21, Dainohara, Aobaku, Sendai, Miyagi, 981-8563, Japan
| | - Fumito Saijo
- Department of Surgery, Tohoku University Hospital, 1-1, Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8574, Japan.
| | - Yu Katayose
- Division of Gastroenterologic and Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan
| | - Mitsuhisa Mutoh
- Department of Surgery, Tohoku Rosai Hospital, 4-3-21, Dainohara, Aobaku, Sendai, Miyagi, 981-8563, Japan
| | - Noriyuki Iwama
- Department of Pathology, Tohoku Rosai Hospital, 4-3-21, Dainohara, Aobaku, Sendai, Miyagi, 981-8563, Japan
| | - Fumie Nakayama
- Department of Pathology, Tohoku Rosai Hospital, 4-3-21, Dainohara, Aobaku, Sendai, Miyagi, 981-8563, Japan
| | - Hiromi Tokumura
- Department of Surgery, Tohoku Rosai Hospital, 4-3-21, Dainohara, Aobaku, Sendai, Miyagi, 981-8563, Japan
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Dutta S, Marbaniang E, Dey B, Lyngdoh BS, Raphael V. Angiomyolipoma of the broad ligament. AUTOPSY AND CASE REPORTS 2020; 10:e2020173. [PMID: 33344297 PMCID: PMC7703467 DOI: 10.4322/acr.2020.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Angiomyolipoma is a benign mesenchymal neoplasm of the renal parenchyma, accounting for 1% of all renal parenchymal tumors. However, this entity may rarely occur in extrarenal sites. Extrarenal angiomyolipoma has been documented in various sites of the body, but angiomyolipoma of the broad ligament was reported in only two cases. We report the reputed third case of angiomyolipoma of the broad ligament in a 33-year-old female, who presented clinically with abdominal distension. With a working diagnosis of low-grade neoplasm, an en-bloc excision of the left broad ligament mass was performed. Based on histopathology and immunohistochemistry, a diagnosis of the classical variant of angiomyolipoma of the left broad ligament was made. The post-operative period was uneventful with no recurrence after 6 months of follow-up.
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Affiliation(s)
- Satya Dutta
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Evarisalin Marbaniang
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Biswajit Dey
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Bifica Sofia Lyngdoh
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Vandana Raphael
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
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Touloumis Z, Giannakou N, Sioros C, Trigka A, Cheilakea M, Dimitriou N, Griniatsos J. Retroperitoneal perivascular epithelioid cell tumours: A case report and review of literature. World J Clin Cases 2019; 7:3524-3534. [PMID: 31750334 PMCID: PMC6854398 DOI: 10.12998/wjcc.v7.i21.3524] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/26/2019] [Accepted: 09/09/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The perivascular epithelioid cell tumour (PEComa) family of tumours mainly includes renal and hepatic angiomyolipomas, pulmonary lymphangioleiomyomatosis and clear cell “sugar” tumour of the lung. Several uncommon tumours with similar morphological and immunophenotypical characteristics arising at a variety of sites (abdominal cavity, digestive tract, retroperitoneum, skin, soft tissue and bones) are also included in the PEComa family and are referred to as PEComas not otherwise specified.
CASE SUMMARY We present a 37-year-old female patient who underwent resection of an 8.5 cm × 8 cm × 4 cm retroperitoneal tumour, which eventually was diagnosed as PEComa of uncertain biological behaviour. Three years after the operation, the patient remains without any evidence of recurrence. A search was performed in the Medline and EMBASE databases for articles published between 1996 and 2018, and we identified 31 articles related to retroperitoneal and perinephric PEComas. We focused on sex, age, maximum dimension, histological and immunohistochemical characteristics of the tumour, follow-up and long-term outcome. Thirty-four retroperitoneal (including the present one) and ten perinephric PEComas were identified, carrying a malignant potential rate of 44% and 60%, respectively. Nearly half of the potentially malignant PEComas presented with or developed metastases during the course of the disease.
CONCLUSION Retroperitoneal PEComas are not as indolent as they are supposed to be. Radical surgical resection constitutes the treatment of choice for localized disease, while mammalian target of the rapamycin (mTOR) inhibitors constitute the most promising therapy for disseminated disease. The role of mTOR inhibitors as adjuvant or neoadjuvant therapies needs to be evaluated in the future.
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Affiliation(s)
- Zisis Touloumis
- Department of Surgery, Athens Medical Group, Athens 11525, Greece
| | - Niki Giannakou
- Department of Pathology, Athens Medical Group, Athens 11525, Greece
| | - Christos Sioros
- Department of Surgery, Athens Medical Group, Athens 11525, Greece
| | - Argiro Trigka
- Department of Surgery, Athens Medical Group, Athens 11525, Greece
| | - Maria Cheilakea
- Emergency Department, Konstantopouleio General Hospital, N. Ionia 14233, Greece
| | - Nikoletta Dimitriou
- 1st Department of Surgery, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - John Griniatsos
- 1st Department of Surgery, National and Kapodistrian University of Athens, Athens 11527, Greece
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7
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Touloumis Z, Giannakou N, Sioros C, Trigka A, Cheilakea M, Dimitriou N, Griniatsos J. Retroperitoneal perivascular epithelioid cell tumours: A case report and review of literature. World J Clin Cases 2019. [DOI: 10.12998/wjcc.v7.i21.3507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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8
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Fırat C, Eryiğit S, Yener S, Demir T, Bozkurt O, Demir Ö, Tuna B, Yörükoğlu K. Adrenokortikal adenomda myelolipomatöz değişiklikler. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.494051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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9
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Gastric Angiomyolipoma Masquerading as Gastric Malignancy. ACG Case Rep J 2019; 5:e96. [PMID: 30643840 PMCID: PMC6317839 DOI: 10.14309/crj.2018.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 09/12/2018] [Indexed: 11/17/2022] Open
Abstract
Gastric angiomyolipoma (AML) is extremely rare, with only 3 cases reported in English literature, all of which presented with upper gastrointestinal bleed, either in the form of hematemesis or melena. A 42-year-old man presented with upper gastrointestinal bleed, the source of which was found to be a large mass in the stomach, which was shown histologically to be gastric AML. This is the fourth but largest tumor (9 × 6 × 5 cm) to be reported to date.
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10
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Sharma G, Jain A, Sharma P, Sharma S, Rathi V, Garg PK. Giant exophytic renal angiomyolipoma masquerading as a retroperitoneal liposarcoma: A case report and review of literature. World J Clin Oncol 2018; 9:162-166. [PMID: 30425941 PMCID: PMC6230916 DOI: 10.5306/wjco.v9.i7.162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/12/2018] [Accepted: 10/23/2018] [Indexed: 02/06/2023] Open
Abstract
A 42-years-old lady, presented with a large retroperitoneal mass which was preoperatively diagnosed as a retroperitoneal liposarcoma following an image guided core biopsy. She underwent a margin-negative resection of the retroperitoneal mass (multi visceral resection - enbloc excision of the retroperitoneal mass with a left nephrectomy and a segmental descending colectomy). The final histopathological examination of the resected specimen confirmed an exophytic renal angiomyolipoma (AML) which was extending into the retroperitoneum. AML is a rare benign tumor arising most commonly from the kidney. It can sometimes present as a diagnostic challenge as it mimics a retroperitoneal liposarcoma or a fat-containing renal cell carcinomas closely. We present this case to share our experience of managing a case of giant exophytic AML which resembled retroperitoneal liposarcoma closely and resulted into an aggressive surgery.
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Affiliation(s)
- Gopal Sharma
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
| | - Ayush Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
| | - Prerit Sharma
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
| | - Sonal Sharma
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
| | - Vinita Rathi
- Department of Radiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
| | - Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
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Wroclawski ML, Baccaglini W, Pazeto CL, Carbajo C, Matushita C, Carneiro A, Pompeo A, Glina S, Pompeo ACL, Cavalcante LB. Extrarenal Angiomyolipoma: differential diagnosis of retroperitoneal masses. Int Braz J Urol 2018; 44:639-641. [PMID: 29211401 PMCID: PMC5996806 DOI: 10.1590/s1677-5538.ibju.2016.0670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 08/07/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
| | - Willy Baccaglini
- Departamento de Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
| | | | - Cristina Carbajo
- Departamento de Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
| | - Chaline Matushita
- Departamento de Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
| | - Arie Carneiro
- Departamento de Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
| | - Alexandre Pompeo
- Departamento de Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
| | - Sidney Glina
- Departamento de Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
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12
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Wang Y, Zhang X, Liu P, Jiang G, Liu W. Duodenal angiomyolipoma with multiple systemic vascular malformations and aneurysms: A case report and literature review. Oncol Lett 2017; 14:6659-6663. [PMID: 29151912 PMCID: PMC5680699 DOI: 10.3892/ol.2017.7011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 07/07/2017] [Indexed: 11/17/2022] Open
Abstract
Angiomyolipomas (AMLs) are barely benign mesenchymal tumors that usually occur in the kidneys and may be associated with tuberous sclerosis complex (TSC). Extrarenal AMLs are markedly rare and infrequently observed in the duodenum. In the present case report, a 22-year-old female patient with duodenal AMLs presenting multiple systemic vascular malformations and aneurysms is described. The patient had a medical history of aneurysm rupture of the right subclavian artery and no other manifestation of TSC. Surgical intervention was performed. Following complete tumor resection, the patient declined to be treated further for vascular lesions. Pathological and immunohistochemical examination confirmed the diagnosis of duodenal AMLs. No tumor recurrence or progression of the vascular lesions was observed within 24 months of follow-up. This case report demonstrates the scarcity of duodenal AMLs with multiple systemic vascular malformations and aneurysms, which may be associated with novel gene mutations or TSC; however, further verification by gene sequencing is required.
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Affiliation(s)
- Yiqiu Wang
- Department of Surgical Oncology, Xuzhou Central Hospital, Southeast University Cancer Institute, Xuzhou, Jiangsu 221009, P.R. China
| | - Xiuli Zhang
- Department of Radiology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221006, P.R. China
| | - Peng Liu
- Department of Surgical Oncology, Xuzhou Central Hospital, Southeast University Cancer Institute, Xuzhou, Jiangsu 221009, P.R. China
| | - Guan Jiang
- Department of Radiology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221006, P.R. China
| | - Wenlou Liu
- Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors and Hubei Cancer Clinical Study Center, Wuhan, Hubei 430071, P.R. China
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Jawahar A, Kazan-Tannus J. Retroperitoneal extrarenal angiomyolipoma at the surgical bed 8 years after a renal angiomyolipoma nephrectomy: A case report and review of literature. Urol Ann 2017; 9:288-292. [PMID: 28794601 PMCID: PMC5532902 DOI: 10.4103/ua.ua_20_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Retroperitoneal extrarenal angiomyolipoma (RERAML) are rare and close mimickers of retroperitoneal liposarcoma on both imaging and histopathology. However, imaging findings including heterogeneity, hyperdensity on unenhanced computed tomography, intralesional hemorrhage, absence of calcifications, low signal intensity on T2-weighted magnetic resonance imaging, and dilated intratumoral vessels can lead to the diagnosis of RERAML. Diagnosis of RERAML can avoid unnecessary surgery since conservative medical management with continued surveillance has been proven to be effective for RERAML whereas surgical resection is the treatment for liposarcoma. Imaging and laboratory follow-up for at least 5 years has been recommended in patients who underwent surgical resection of angiomyolipoma (AML). We present a case of RERAML in an asymptomatic patient whose AML recurred in the surgical bed 8 years after an ipsilateral nephrectomy for renal AML.
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Affiliation(s)
- Anugayathri Jawahar
- Department of Radiology, Loyola University Medical Center, Maywood, Illinois 60153, USA
| | - Joao Kazan-Tannus
- Department of Radiology, Loyola University Medical Center, Maywood, Illinois 60153, USA
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Venyo AKG. A Review of the Literature on Extrarenal Retroperitoneal Angiomyolipoma. Int J Surg Oncol 2016; 2016:6347136. [PMID: 26989509 PMCID: PMC4773571 DOI: 10.1155/2016/6347136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 01/02/2016] [Accepted: 01/05/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Extrarenal retroperitoneal angiomyolipomas are rare. AIM To review the literature. RESULTS Angiomyolipomas, previously classified as hamartomas, are now classified as benign tumours. Thirty cases of primary retroperitoneal angiomyolipomas have been reported. Diagnosis of the disease upon is based radiological and pathological findings of triphasic features of (a) fat and (b) blood vessels and myoid tissue. Immunohistochemistry tends to be positive for HMB45, MART1, HHF35, calponin, NKI-C3, and CD117. The lesion is common in women. Treatment options have included the following: (a) radical surgical excision of the lesion with renal sparing surgery or radical nephrectomy in cases where malignant tumours could not be excluded and (b) selective embolization of the lesion alone or prior to surgical excision. One case of retroperitoneal angiomyolipoma was reported in a patient 15 years after undergoing radical nephrectomy for angiomyolipoma of kidney and two cases of distant metastases of angiomyolipoma have been reported following radical resection of the tumour. CONCLUSIONS With the report of two cases of metastases ensuing surgical resection of the primary lesions there is need for academic pathologists to debate and review angiomyolipomas to decide whether to reclassify angiomyolipomas as slow-growing malignant tumours or whether the reported cases of metastases were de novo tumours or metastatic lesions.
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Affiliation(s)
- A S Ammanagi
- Department of Pathology, S. N. Medical College, Bagalkot, Karnataka, India
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