Renal angiomyolipoma: embolotherapy with a mixture of alcohol and iodized oil.
OBJECTIVE
To evaluate the efficacy of superselective embolotherapy of renal angiomyolipomas with a 1:3 mixture of iodized oil and absolute ethanol as embolic material.


METHODS
Fifteen patients with 21 symptomatic renal angiomyolipomas were treated with embolization. The sizes of tumors ranged from 6 cm to 15 cm (mean, 8.6 cm). Six of 15 patients were diagnosed with tuberous sclerosis. The diagnoses of renal angiomyolipoma were made from characteristic computed tomographic findings. All angiomyolipomas were successfully embolized with a 1:3 mixture of iodized oil and absolute ethanol (2-20 mL; mean, 8.5 mL). Patients were followed up from 5 months to 8 years (mean, 35.6 months). The efficacy of embolotherapy was evaluated by symptom-free period, immediate and late complications, and follow-up imaging findings, including changes in tumor size.


RESULTS
Thirteen patients showed no symptom recurrence during follow-up periods from 3 months to 8 years. Two patients with incomplete embolization required repeated embolization because of the recurrence of perinephric hematoma or other symptoms. Twelve patients experienced mild postembolization syndrome, which subsided with conservative management. A moderate amount of pleural effusion developed in one patient and was managed with percutaneous drainage. No patients developed any severe late complications, hypertension, or renal failure. During the follow-up period, 12 tumors decreased in size, whereas there was no change in eight tumors, and in one tumor imaging follow-up was not available.


CONCLUSIONS
Embolization with a 1:3 mixture of iodized oil and absolute ethanol is an effective method of treatment in renal angiomyolipoma with favorable results. But incomplete embolization of angiomyolipoma results in a high incidence of recurrent symptoms due to bleeding.
Lee
W
W
Department of Radiology, Seoul National University College of Medicine, Korea.
Kim
T S
TS
Chung
J W
JW
Han
J K
JK
Kim
S H
SH
Park
J H
JH
D000293:Adolescent; D000328:Adult; D000792:Angiography; D018207:Angiomyolipoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage*; D007680:Kidney Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D000431:Ethanol; D007459:Iodized Oil