[The conservative treatment of an isolated angiomyolipoma of the kidney on the basis of one case treated by tumorectomy ex-vivo (author's transl)].
The authors report a quite exceptional case of isolated angiomyolipoma of one kidney in the absence of any manifestation of phakomatosis. Discovery of the tumour led to special investigations which confirmed the solid and hypervascularised nature of the tumour. A doubt remained with regard to its precise nature, and hence an extended nephrectomy, though without damage to the vessels at the time of section. The kidney was cooled and preserved by perfusion which allowed time for adequate histological study. The diagnosis of angiomyolipoma being confirmed, without the slightest risk of dissemination if by chance it had not been a benign tumour, the kidney was transplanted into the lumbar fossa via its own vessels with an excellent result. The authors discuss two problems on the basis of this case: 1) That of preoperative diagnostic difficulties: the scanner provides valuable information when it reveals the presence of intra-tumoral fatty tissue. 2) Difficulties in management when the benign nature of the lesion cannot be confirmed before histological examination. The solution adopted: routine extended nephrectomy with ex-vivo perfusion of the kidney making it possible to obey the basic rules of oncology. Frozen section biopsy confirms the diagnosis of angiomyolipoma. It is then possible to auto-transplant the kidney after tumorectomy.
D000328:Adult; D005260:Female; D006391:Hemangioma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008067:Lipoma / Q000175:diagnosis / Q000601:surgery*; D009392:Nephrectomy
Traitement conservateur de l'angiomyolipome isolé du rein. A propos d'un cas traité par tumorectomie ex vivo.