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Management of Renal Angiomyolipomas Associated With Tuberous Sclerosis Complex
|タイトル: ||Management of Renal Angiomyolipomas Associated With Tuberous Sclerosis Complex|
|著者: ||Harabayashi, Toru 著作を一覧する|
Shinohara, Nobuo 著作を一覧する
Katano, Hidenori 著作を一覧する
Nonomura, Katsuya 著作を一覧する
Shimizu, Tadashi 著作を一覧する
Koyanagi, Tomohiko 著作を一覧する
|発行日: ||2004年 1月|
|出版者: ||Elsevier Inc.|
|誌名: ||The Journal of Urology|
|出版社 DOI: ||10.1097/01.ju.0000100100.36354.61|
|抄録: ||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.|
|資料タイプ: ||article (author version)|
|出現コレクション:||雑誌発表論文等 (Peer-reviewed Journal Articles, etc)|
提供者: 原林 透