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Management of Renal Angiomyolipomas Associated With Tuberous Sclerosis Complex

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Title: Management of Renal Angiomyolipomas Associated With Tuberous Sclerosis Complex
Authors: Harabayashi, Toru Browse this author
Shinohara, Nobuo Browse this author →KAKEN DB
Katano, Hidenori Browse this author
Nonomura, Katsuya Browse this author
Shimizu, Tadashi Browse this author
Koyanagi, Tomohiko Browse this author
Keywords: angiomyolipoma
tuberous sclerosis
Issue Date: Jan-2004
Publisher: Elsevier Inc.
Journal Title: The Journal of Urology
Volume: 171
Issue: 1
Start Page: 102
End Page: 105
Publisher DOI: 10.1097/01.ju.0000100100.36354.61
PMID: 14665854
Abstract: Purpose: Intensive management is generally recommended for angiomyolipomas associated with tuberous sclerosis complex (TSC), which are known to have a more aggressive nature than sporadic tumors. In this study we evaluated the management of these tumors. Materials and Methods: The records of 6 men and 6 women with TSC and a mean age of 28.8 years) with angiomyolipomas treated from 1984 to 2000 were retrospectively analyzed. All patients had bilateral multiple tumors (mean size 6.6 cm). There were 10 lesions classified as small (less than 4 cm), 6 medium (4 to 10 cm) and 8 large lesions (10 cm or greater). Computerized tomography was repeated annually for followup observation and semiannually after embolization. Results: Excluding from study 3 tumors treated prophylactically intervention was required in 20%, 50% and 100% of small, medium and large tumors, respectively. Among 14 tumors followed by observation, 8 grew and 4 required intervention. Uncontrollable hemorrhage did not develop in any patient. While some tumors showed remarkable growth in decade 3, growth did not exceed 1.5 cm per year. Embolization was performed in 11 tumors and tumors shrank in 10. Although 1 patient experienced renal atrophy, all patients but 1 are alive without renal failure with a mean followup of 60 months. Conclusions: Although asymptomatic angiomyolipomas associated with TSC grow gradually, severe hemorrhage is rare and most tumors can be managed conservatively with annual computerized tomography. Embolization is the first choice of intervention but should be reserved until symptoms develop.
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 原林 透

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