Evolving horizons in renal angiomyolipoma: two decades of management strategies and clinical perspectives in a single institutional study

* The preliminary results of this study were presented as a podium presentation at the 38th Annual European Association of Urology (EAU 23) Congress in Milan.

Abstract

Objective

To assess various management options for renal angiomyolipoma (AML) to guide clinical practice.

Methods

A single center retrospectively reviewed an AML series from 2002 to 2022. The image reports and chart reviews of patients who received two abdominal scans at least 6 months between the first and last scans were assessed.

Results

A total of 203 patients with 209 tumors were identified and followed up for a median of 42.6 months. Active surveillance (AS) was the most frequently selected option (70.9% of cases). Interventions were required for 59 AMLs, of which 20 were treated with embolization, 29 with partial nephrectomy, 9 with radical nephrectomy, and 1 with radiofrequency (RF) ablation. The median size of the lesions at intervention was 5 cm. The average growth rate of the lesions was 0.12 cm/year, and there was a significant difference in the average growth rate of lesions ≤4 cm and those >4 cm (0.11 vs. 0.24 cm/year; p = 0.0046).

Conclusion

This series on AMLs confirms that lesions >4 cm do not require early intervention based on size alone. Appropriately selected cases of renal AML can be managed by AS.

KEYWORDS: Angiomyolipoma; active surveillance; embolization; nephrectomy; nephron-sparing surgery

Acknowledgment

None.

Informed consent

Informed consent could not be taken from the patients due to the retrospective design of the study.

Author contributions

A. K. Project development, data collection, data analysis, interpretation of data, manuscript writing. A. Y. Project development, manuscript writing, manuscript editing, supervision. A. I. Study concept and design, data collection, manuscript editing. F. K. Administrative, technical, or material support, data collection. K. N. B. Statistical analysis, interpretation of data M. C. Draft of manuscript writing, critical revision of the manuscript. Ö. A. Manuscript editing, interpretation of data. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Disclosure statement

The authors report there are no competing interests to declare.

Data availability statement

The datasets are available from the corresponding author.

Notes

* The preliminary results of this study were presented as a podium presentation at the 38th Annual European Association of Urology (EAU 23) Congress in Milan.

Additional information

Funding

The authors reported there is no funding associated with the work featured in this article.