Angiomyolipoma: Diagnosis and Treatment

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Abstract
Four cases of renal angiomyolipoma are presented, 3 of which were diagnosed in nontuberous sclerosis patients. In 1 case the diagnosis was made preoperatively and in another case it was made intraoperatively, allowing for preservation of functioning renal parenchyma. The 2nd successful kidney transplant in a patient with tuberous sclerosis and renal failure is reported. One cannot always differentiate renal angiomyolipomas from adenocarcinoma. If the classical angiographic findings of sacculated pseudoaneurysms supplied by the interlobular and interlobar arteries are present nonoperative observation or limited surgery with preservation of renal tissue is possible. Knowledge of the gross pathologic appearance and the syndrome of tuberous sclerosis will allow one to make a preoperative or intraoperative diagnosis with confidence.