Case 56

 A sixty five-year-old female had received hysterectomy for uterine myoma twelve years ago and surgical replacement of right knee joint for degenerative osteoarthritis three years ago. She had physical checkup last year and abdominal echo revealed angiomyolipoma of the right kidney. Then, she came to our hospital for further examination. Non-enhanced CT at that time showed 4.3 cm-sized tumor with partial lipid component in the right kidney, indicating a compatible image of angiomyolipoma. Non-enhanced and enhanced CT this year showed the tumor increased a little bit to 4.5 cm in size (Fig.1,2). The urologist recommended her to receive prophylactic transcatheter arterial embolization because although angiomyolipoma is not a malignant tumor, her angiomyolipoma owns solid components and is growing extrarenally, anticipating the possible rupture and the retroperitoneal hemorrhage. She agreed with his suggestion and consented to receive transcatheter arterial embolization.

What is the appropriate management for extra-renal growing angiomyolipoma ?

1. Embolization with gelatin sponge particles

2. Embolization with n-butyl cyanoacrylate

3. Embolization with microcoils

4. Embolization with ethanol

5. Embolization with ethanol + lipiodol

answer

2017.5.31