PMID- 31959574
OWN - NLM
STAT- MEDLINE
DCOM- 20201026
LR  - 20211204
IS  - 0219-3108 (Electronic)
IS  - 1015-9584 (Linking)
VI  - 43
IP  - 10
DP  - 2020 Oct
TI  - Renal angiomyolipoma with tuberous sclerosis complex: How it differs from 
      sporadic angiomyolipoma in both management and care.
PG  - 967-972
LID - S1015-9584(20)30003-8 [pii]
LID - 10.1016/j.asjsur.2019.12.008 [doi]
AB  - Renal angiomyolipoma (AML) is the most common benign tumor of the kidney. It 
      consists of blood vessels, smooth muscle and fat components in varying 
      proportions. AML is divided into the sporadic type and tuberous sclerosis complex 
      (TSC)-associated type. TSC-associated AML develops at a younger age and tends to 
      exhibit a much faster growth rate over time than sporadic AML. AMLs are 
      classified as classic AML, fat-poor AML and epithelioid AML. Epithelioid AML, 
      though rare, shows aggressive behavior leading to distant metastasis and 
      mortality. TSC-associated AML is more likely to have an epithelioid component 
      than sporadic AML. Active surveillance is the suggested management for small AML. 
      Clinical intervention is mainly indicated when there is a substantial risk of 
      rupture. Minimally invasive therapies, including partial nephrectomy, 
      transcatheter arterial embolization, and mammalian target of rapamycin (mTOR) 
      inhibitor treatment are employed for patients who require treatment. An updated 
      algorithm for the management of AML is herein described. According to this 
      algorithm, treatment intervention is recommended for TSC-associated AML >3 cm, 
      even in asymptomatic cases. In cases with asymptomatic sporadic AML >4 cm in size 
      or with an intra-tumoral aneurysm of >5 mm, treatment, including transcatheter 
      arterial embolization or partial nephrectomy, is advised. The major complication 
      of AML is intra-tumoral or retroperitoneal hemorrhage due to rupture that may be 
      serious and life threatening. Thus, correct diagnosis, proper observation, and 
      appropriate treatment are very important in the management of renal AML.
CI  - Copyright (c) 2020. Published by Elsevier Taiwan LLC.
FAU - Hatano, Takashi
AU  - Hatano T
AD  - Department of Urology, JR Tokyo General Hospital, Japan. Electronic address: 
      hatano-t@jreast.co.jp.
FAU - Egawa, Shin
AU  - Egawa S
AD  - Department of Urology, Jikei University School of Medicine, Japan.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20200117
PL  - Netherlands
TA  - Asian J Surg
JT  - Asian journal of surgery
JID - 8900600
RN  - 9HW64Q8G6G (Everolimus)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Age Factors
MH  - Algorithms
MH  - Angiomyolipoma/classification/complications/pathology/*therapy
MH  - Embolization, Therapeutic/*methods
MH  - Everolimus/pharmacology/*therapeutic use
MH  - Hemorrhage/etiology
MH  - Humans
MH  - Kidney Neoplasms/classification/pathology/*therapy
MH  - Minimally Invasive Surgical Procedures/methods
MH  - Nephrectomy/*methods
MH  - Retroperitoneal Space
MH  - Rupture, Spontaneous
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
MH  - Tuberous Sclerosis/*complications
OTO - NOTNLM
OT  - Hemorrhage
OT  - Mammalian target of rapamycin inhibitor
OT  - Renal angiomyolipoma
OT  - Transcatheter arterial embolization
OT  - Tuberous sclerosis complex
COIS- Declaration of competing interest The authors declare no conflict of interest.
EDAT- 2020/01/22 06:00
MHDA- 2020/10/27 06:00
CRDT- 2020/01/22 06:00
PHST- 2019/08/05 00:00 [received]
PHST- 2019/12/14 00:00 [revised]
PHST- 2019/12/27 00:00 [accepted]
PHST- 2020/01/22 06:00 [pubmed]
PHST- 2020/10/27 06:00 [medline]
PHST- 2020/01/22 06:00 [entrez]
AID - S1015-9584(20)30003-8 [pii]
AID - 10.1016/j.asjsur.2019.12.008 [doi]
PST - ppublish
SO  - Asian J Surg. 2020 Oct;43(10):967-972. doi: 10.1016/j.asjsur.2019.12.008. Epub 
      2020 Jan 17.