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RENAL ANJİOMYOLİPOM OLGULARININ 5 YILA KADAR TAKİP GÖRÜNTÜLEME BULGULARI

Yıl 2019, , 115 - 120, 22.07.2019
https://doi.org/10.18229/kocatepetip.595047

Öz

AMAÇ: Bu çalışmanın amacı takip görüntülemeleri olan renal anjiomyolipom (AML) olgularını tümör boyut değişikliği ve gelişen komplikasyonlar açısından değerlendirmektir.
GEREÇ VE YÖNTEM: Görüntüleme tetkikleri ile renal AML tanısı konan ve takip görüntülemeleri bulunan olguların tümör boyutundaki değişiklikler, takipte gelişen komplikasyonlar ve yapılan girişimsel işlemler retrospektif olarak incelenmiştir.
BULGULAR: Abdominal görüntüleme ile tanısı konan 149 renal AML olgusunun 41’ ine (18E, 23K) takip görüntüleme yapıldığı saptanmıştır. Ortalama yaş 58.4 (min-maks: 31-81)’ dür. Takip süresi ortalama 28.3 ay (min-maks: 3-60)’ dır. 38 olguda (%93) tek taraflı (21 sol (%51), 17 sağ (%41)), 3 olguda (%7) çift taraflı AML saptanmıştır. İlk görüntülemede ortalama AML boyutu 39.2mm (min-maks: 5-363)’ dir. 28 olguda (%68) AML boyutu 40mm’ den küçük, 13 olguda (%32) ise 40mm’ den büyüktür. 32 olguda (%78) tümör boyutu değişmemiştir. 5 olguda (%12) tümör boyutunda artış mevcut olup ortalama artış 6 mm (min-maks: 3-10 mm)’ dir. 3 olguda (%7) takipte kanama görülmüştür. 3 olguya arteryel embolizasyon işlemi yapılmış, takipte ortalama boyut azalması 12.5 mm (min-maks: 10-15)’ dir. 1 olguya cerrahi rezeksiyon yapılmıştır.
SONUÇ: Renal AML’ ların boyutu genel olarak değişmemekle birlikte %12 olguda boyut artışı görülebilir. Semptomatik, büyük boyutlu ve takipte boyut artışı gösteren AML olgularında retroperitoneal kanama ve renal hasar gibi komplikasyonlardan korunmak için girişimsel işlemler yapılabilir.

Kaynakça

  • 1. Al-Thani H, El-Menyar A, Al-Sulaiti M, et al. Clinical Presentation, Management, and Outcome of Patients with Incidental Renal Angiomyolipoma in Qatar. Oman Med J 2014;6:419-24.
  • 2. Wang C, Li X, Peng L, Gou X, Fan J. An update on recent developments in rupture of renal angiomyolipoma. Medicine(Baltimore)2018;97(16):e0497. doi:10.1097/MD.0000000000010497.
  • 3. Lee KH, Tsai HY, Kao YT, et al. Clinical behavior and management of three types of renal angiomyolipomas. J Formos Med Assoc 2018 Mar 14. pii: S0929-6646(17)30689-7. doi: 10.1016/j.jfma.2018.02.012. [Epub ahead of print]
  • 4. Lin CY, Chen HY, Ding HJ, Yen KY, Kao CH. FDG PET or PET/CT in evaluation of renal angiomyolipoma. Korean J Radiol 2013;14(2):337-42.
  • 5. Nelson CP, Sanda MG. Contemporary diagnosis and management of renal angiomyolipoma. J Urol 2002;168(4 Pt 1):1315-25.
  • 6. Park JH, Lee C, Suh JH, Kim G, Song B, Moon KC. Renal epithelioid angiomyolipoma: histopathologic review, immunohistochemical evaluation and prognostic significance. Pathol Int 2016;66(10):571e7.
  • 7. Koo KC, Kim WT, Ham WS, Lee JS, Ju HJ, Choi YD. Trends of presentation and clinical outcome of treated renal angiomyolipoma. Yonsei Med J 2010;51(5):728-34.
  • 8. Fittschen A, Wendlik I, Oeztuerk S, et al. Prevalence of sporadic renal angiomyolipoma: a retrospective analysis of 61,389 in- and out-patients. Abdom Imaging 2014;39(5):1009-13.
  • 9. Wagner BJ, Wong-You-Cheong JJ, Davis Jr CJ. Adult renal hamartomas. Radiographics 1997;17(1):155e69.
  • 10. Kothary N, Soulen MC, Clark TW, et al. Renal angiomyolipoma: long-term results afer arterial embolization. J Vasc Interv Radiol 2005;16(1):45-50.
  • 11. Schieda N, Kielar AZ, Al Dandan O, et al. Ten uncommon and unusual variants of renal angiomyolipoma (AML): radiologic-pathologic correlation. Clin Radiol 2015;70:206–20.
  • 12. Israel GM, Hindman N, Hecht E, et al. The use of opposed-phase chemical shift MRI in the diagnosis of renal angiomyolipomas. AJR Am J Roentgenol 2005;184:1868–72.
  • 13. Wright T, Sooriakumaran P. Renal angiomyolipoma presenting with massive retroperitoneal haemorrhage due to deranged clotting factors: a case report. Cases J 2008;1(1):213.
  • 14. Halpenny D, Snow A, McNeill G, Torreggiani WC. The radiological diagnosis and treatment of renal angiomyolipoma-current status. Clin Radiol 2010;65(2):99-108.
  • 15. Oesterling JE, Fishman EK, Goldman SM, Marshall FF. Te management of renal angiomyolipoma. J Urol 1986;135(6):1121-4.
  • 16. Prando A. Renal angiomyolipoma: relationships between tumor size, aneurysm formation, and rupture. Int Braz J Urol 2002;28(6):578e9.
  • 17. Kuusk T, Biancari F, Lane B, et al. Treatment of renal angiomyolipoma: pooled analysis of individual patient data. BMC Urol 2015;15:123.
  • 18. Prischl FC, Spottl P. Spontaneous rupture of angiomyolipoma of the kidney. Wien Klin Wochenschr 2017;129:217–8.
  • 19. Park HK, Zhang S, Wong MK, Kim HL. Clinical presentation of epithelioid angiomyolipoma. Int J Urol 2007;14(1):21-5.
  • 20. Lane BR, Aydin H, Danforth TL, et al. Clinical correlates of renal angiomyolipoma subtypes in 209 patients: classic, fat poor, tuberous sclerosis associated and epithelioid. J Urol 2008;180(3):836-43. 120
  • 21. Fiore F, Del Prete M, Franco R, et al. Transarterial embolization (TAE) is equally effective and slightly safer than transarterial chemoembolization (TACE) to manage liver metastases in neuroendocrine tumors. Endocrine 2014;47(1):177e82.
  • 22. Seyam RMBN, Kattan SA, Mokhtar AA, et al. Changing trends in presentation, diagnosis and management of renal angiomyolipoma: comparison of sporadic and tuberous sclerosis complex-associated forms. Urology 2008;72:1077–82.

FOLLOW-UP IMAGING FINDINGS OF RENAL ANGIOMYOLIPOMA UP TO 5 YEARS

Yıl 2019, , 115 - 120, 22.07.2019
https://doi.org/10.18229/kocatepetip.595047

Öz

OBJECTIVE: The objective of this study is to evaluate the imaging and follow-up findings of renal angiomyolipomas (AML) in terms of tumor size difference and developing complications.

MATERIAL AND METHODS: Changes in tumor size, complications developed during follow-up, and interventional procedures performed were retrospectively reviewed in patients with renal AML.

RESULTS: 149 patients diagnosed as renal AML by abdominal imaging. 41 (18E, 23K) of them had follow-up imaging. The mean age was 58.4 (min-max: 31-81). The mean follow-up period was 28.3 months (min-max: 3-60). Unilateral AML was found in 38 patients (93%) (21 left (51%), 17 right (41%)) and bilateral AML was found in 3 (7%) patients. The mean AML size in initial imaging was 39.2mm (min-max: 5-363). 28 cases (68%) were smaller than 40mm and 13 cases (32%) were larger than 40mm. In 32 cases (78%) the tumor size was stable. There is an increase in tumor size in 5 cases (12%) with a mean increase of 6 mm (min-max: 3-10 mm). In 3 cases (7%) bleeding was observed on follow-up. Three patients underwent arterial embolization and the mean size reduction was 12.5 mm (min-max: 10-15). 1 patient underwent surgical resection.

CONCLUSIONS: The diameter of renal AMLs are usually stable, but 12% of them may increase in size on follow-up. Interventional procedures can be performed to prevent complications such as retroperitoneal hemorrhage, renal damage in symptomatic, large-sized AML patients and progression in size on follow-up.

Kaynakça

  • 1. Al-Thani H, El-Menyar A, Al-Sulaiti M, et al. Clinical Presentation, Management, and Outcome of Patients with Incidental Renal Angiomyolipoma in Qatar. Oman Med J 2014;6:419-24.
  • 2. Wang C, Li X, Peng L, Gou X, Fan J. An update on recent developments in rupture of renal angiomyolipoma. Medicine(Baltimore)2018;97(16):e0497. doi:10.1097/MD.0000000000010497.
  • 3. Lee KH, Tsai HY, Kao YT, et al. Clinical behavior and management of three types of renal angiomyolipomas. J Formos Med Assoc 2018 Mar 14. pii: S0929-6646(17)30689-7. doi: 10.1016/j.jfma.2018.02.012. [Epub ahead of print]
  • 4. Lin CY, Chen HY, Ding HJ, Yen KY, Kao CH. FDG PET or PET/CT in evaluation of renal angiomyolipoma. Korean J Radiol 2013;14(2):337-42.
  • 5. Nelson CP, Sanda MG. Contemporary diagnosis and management of renal angiomyolipoma. J Urol 2002;168(4 Pt 1):1315-25.
  • 6. Park JH, Lee C, Suh JH, Kim G, Song B, Moon KC. Renal epithelioid angiomyolipoma: histopathologic review, immunohistochemical evaluation and prognostic significance. Pathol Int 2016;66(10):571e7.
  • 7. Koo KC, Kim WT, Ham WS, Lee JS, Ju HJ, Choi YD. Trends of presentation and clinical outcome of treated renal angiomyolipoma. Yonsei Med J 2010;51(5):728-34.
  • 8. Fittschen A, Wendlik I, Oeztuerk S, et al. Prevalence of sporadic renal angiomyolipoma: a retrospective analysis of 61,389 in- and out-patients. Abdom Imaging 2014;39(5):1009-13.
  • 9. Wagner BJ, Wong-You-Cheong JJ, Davis Jr CJ. Adult renal hamartomas. Radiographics 1997;17(1):155e69.
  • 10. Kothary N, Soulen MC, Clark TW, et al. Renal angiomyolipoma: long-term results afer arterial embolization. J Vasc Interv Radiol 2005;16(1):45-50.
  • 11. Schieda N, Kielar AZ, Al Dandan O, et al. Ten uncommon and unusual variants of renal angiomyolipoma (AML): radiologic-pathologic correlation. Clin Radiol 2015;70:206–20.
  • 12. Israel GM, Hindman N, Hecht E, et al. The use of opposed-phase chemical shift MRI in the diagnosis of renal angiomyolipomas. AJR Am J Roentgenol 2005;184:1868–72.
  • 13. Wright T, Sooriakumaran P. Renal angiomyolipoma presenting with massive retroperitoneal haemorrhage due to deranged clotting factors: a case report. Cases J 2008;1(1):213.
  • 14. Halpenny D, Snow A, McNeill G, Torreggiani WC. The radiological diagnosis and treatment of renal angiomyolipoma-current status. Clin Radiol 2010;65(2):99-108.
  • 15. Oesterling JE, Fishman EK, Goldman SM, Marshall FF. Te management of renal angiomyolipoma. J Urol 1986;135(6):1121-4.
  • 16. Prando A. Renal angiomyolipoma: relationships between tumor size, aneurysm formation, and rupture. Int Braz J Urol 2002;28(6):578e9.
  • 17. Kuusk T, Biancari F, Lane B, et al. Treatment of renal angiomyolipoma: pooled analysis of individual patient data. BMC Urol 2015;15:123.
  • 18. Prischl FC, Spottl P. Spontaneous rupture of angiomyolipoma of the kidney. Wien Klin Wochenschr 2017;129:217–8.
  • 19. Park HK, Zhang S, Wong MK, Kim HL. Clinical presentation of epithelioid angiomyolipoma. Int J Urol 2007;14(1):21-5.
  • 20. Lane BR, Aydin H, Danforth TL, et al. Clinical correlates of renal angiomyolipoma subtypes in 209 patients: classic, fat poor, tuberous sclerosis associated and epithelioid. J Urol 2008;180(3):836-43. 120
  • 21. Fiore F, Del Prete M, Franco R, et al. Transarterial embolization (TAE) is equally effective and slightly safer than transarterial chemoembolization (TACE) to manage liver metastases in neuroendocrine tumors. Endocrine 2014;47(1):177e82.
  • 22. Seyam RMBN, Kattan SA, Mokhtar AA, et al. Changing trends in presentation, diagnosis and management of renal angiomyolipoma: comparison of sporadic and tuberous sclerosis complex-associated forms. Urology 2008;72:1077–82.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler-Araştırma Yazıları
Yazarlar

Erdem Yılmaz

Yayımlanma Tarihi 22 Temmuz 2019
Kabul Tarihi 6 Kasım 2018
Yayımlandığı Sayı Yıl 2019

Kaynak Göster

APA Yılmaz, E. (2019). RENAL ANJİOMYOLİPOM OLGULARININ 5 YILA KADAR TAKİP GÖRÜNTÜLEME BULGULARI. Kocatepe Tıp Dergisi, 20(3), 115-120. https://doi.org/10.18229/kocatepetip.595047
AMA Yılmaz E. RENAL ANJİOMYOLİPOM OLGULARININ 5 YILA KADAR TAKİP GÖRÜNTÜLEME BULGULARI. KTD. Temmuz 2019;20(3):115-120. doi:10.18229/kocatepetip.595047
Chicago Yılmaz, Erdem. “RENAL ANJİOMYOLİPOM OLGULARININ 5 YILA KADAR TAKİP GÖRÜNTÜLEME BULGULARI”. Kocatepe Tıp Dergisi 20, sy. 3 (Temmuz 2019): 115-20. https://doi.org/10.18229/kocatepetip.595047.
EndNote Yılmaz E (01 Temmuz 2019) RENAL ANJİOMYOLİPOM OLGULARININ 5 YILA KADAR TAKİP GÖRÜNTÜLEME BULGULARI. Kocatepe Tıp Dergisi 20 3 115–120.
IEEE E. Yılmaz, “RENAL ANJİOMYOLİPOM OLGULARININ 5 YILA KADAR TAKİP GÖRÜNTÜLEME BULGULARI”, KTD, c. 20, sy. 3, ss. 115–120, 2019, doi: 10.18229/kocatepetip.595047.
ISNAD Yılmaz, Erdem. “RENAL ANJİOMYOLİPOM OLGULARININ 5 YILA KADAR TAKİP GÖRÜNTÜLEME BULGULARI”. Kocatepe Tıp Dergisi 20/3 (Temmuz 2019), 115-120. https://doi.org/10.18229/kocatepetip.595047.
JAMA Yılmaz E. RENAL ANJİOMYOLİPOM OLGULARININ 5 YILA KADAR TAKİP GÖRÜNTÜLEME BULGULARI. KTD. 2019;20:115–120.
MLA Yılmaz, Erdem. “RENAL ANJİOMYOLİPOM OLGULARININ 5 YILA KADAR TAKİP GÖRÜNTÜLEME BULGULARI”. Kocatepe Tıp Dergisi, c. 20, sy. 3, 2019, ss. 115-20, doi:10.18229/kocatepetip.595047.
Vancouver Yılmaz E. RENAL ANJİOMYOLİPOM OLGULARININ 5 YILA KADAR TAKİP GÖRÜNTÜLEME BULGULARI. KTD. 2019;20(3):115-20.

Cited By

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