Renal angiomyolipoma in children: diagnositc difficulty in 3 patients

The Journal of Urology
Z TchaprassianG Cecchetto

Abstract

Because angiomyolipoma is less common in children than in adults, its diagnosis can be difficult. We present 3 cases of pediatric angiomyolipoma in which diagnostic problems resulted due to the presenting characteristics. We report on 3 children with unilateral renal angiomyolipoma. Computerized tomography (CT) and ultrasonography revealed 3 large renal masses, 20, 7 and 8 cm. in diameter, respectively. A correct diagnosis was not made preoperatively in any case by CT, ultrasound or fine needle biopsy. Wilms tumor was suspected in the first patient who received preoperative chemotherapy. Imaging was inconclusive in the other 2 cases. All patients underwent surgical exploration and subsequent nephrectomy due to the large size of the tumor. At followup 33, 23 and 13 months postoperatively all children were well without signs of recurrence. It has been reported that the demonstration of fat on renal ultrasound and CT can diagnose angiomyolipoma in 95% of the cases. Most radiologists rely solely on CT demonstration of lipid density in the renal mass to diagnose angiomyolipoma but the identification at imaging of lipid tissue may be difficult in small tumors. In our cases the fat content of the tumors was less than 10% despite the l...Continue Reading

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Citations

Jun 23, 2006·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Elisabeth B WinterkornElizabeth A Thiele
Jan 6, 2001·International Journal of Urology : Official Journal of the Japanese Urological Association·I Türker KöksalT Kaplancan
Apr 21, 2007·Journal of Endourology·Antoine LefloreBradley F Schwartz
Aug 20, 2005·Nephrology·S Y Chan, W K Y Chan
May 11, 2012·Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society·Rita AlaggioSara O Vargas

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