title: Bilateral giant renal angiomyolipoma associated with hepatic lipoma in a patient with tuberous sclerosis.
abstract: OBJECTIVE
  To report a case of bilateral giant renal angiomyolipoma associated with tuberous sclerosis, with successful treatment, and to review the literature concerning angiomyolipoma treatment.
  
  
  METHODS
  Patient with tuberous sclerosis and angiomyolipoma diagnosed by ultrasonography during her pregnancy. At that time, the angiomyolipoma on the right side was 9 cm in diameter. Conservative management was selected during her pregnancy. The patient returned 7 years later, with a 24.7 x 19.2 x 10.7 cm tumor on the right side and another of 13 x 11.5 x 6.5 cm on the left side, in addition to multiple small angiomyolipomas. A nephron-sparing surgery with tumoral enucleation was performed on the right side, and after 3 months, the tumor on the left side was removed. Renal function in the post-operative period was preserved, and contrast medium progression was uniform and adequate in both kidneys.
  
  
  CONCLUSIONS
  We conclude that an angiomyolipoma larger than 4 cm should be removed surgically, since they have a greater growth rate and pose a risk of hemorrhage. Resection of smaller tumors is safe and has decreased morbidity. Tumoral enucleation is an effective treatment method that preserves kidney function.
authors.affiliation: Surgery Department, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Brazil.
authors.forename: Edison Daniel
authors.initials: ED
authors.lastname: Schneider-Monteiro
authors.forename: Antonio Marmo
authors.initials: AM
authors.lastname: Lucon
authors.forename: André Avarese
authors.initials: AA
authors.lastname: de Figueiredo
authors.forename: Aldo Junqueira
authors.initials: AJ
authors.lastname: Rodrigues Junior
authors.forename: Sami
authors.initials: S
authors.lastname: Arap
mesh_terms: D000328:Adult; D018207:Angiomyolipoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008067:Lipoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D009392:Nephrectomy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000601:surgery; D011859:Radiography; D014402:Tuberous Sclerosis / Q000150:complications*