Download PDF
CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(03): 199-202
DOI: 10.1055/s-0039-1683948
Case Report
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Embolization of Ruptured Renal Angiomyolipoma in Puerpera

Embolização de angiomiolipoma renal roto em puérpera
Adenauer Marinho de Oliveira Góes Junior 
1   Department of Vascular Surgery, Centro Universitário do Estado do Pará, Belém, PA, Brazil
3   Department of Surgical Habilities, Universidade Federal do Pará, Belém, Pará, Brazil
5   Department of Endovascular Surgery, Hospital Geral Unimed (HGU), Belém, PA, Brazil
,
Salim Abdon Haber Jeha
4   Department of Vascular Surgery, Universidade Federal do Pará, Belém, Pará, Brazil
5   Department of Endovascular Surgery, Hospital Geral Unimed (HGU), Belém, PA, Brazil
,
Carolina Pinheiro de Oliveira
2   School of Medicine, Centro Universitário do Estado do Pará, Belém, PA, Brazil
,
Daniel Arthur Santos dos Santos
2   School of Medicine, Centro Universitário do Estado do Pará, Belém, PA, Brazil
› Author Affiliations
Further Information

Publication History

29 August 2018

22 October 2018

Publication Date:
13 March 2019 (online)

   Permissions and Reprints

Abstract

Angiomyolipomas (AMLs) are rare benign tumors derived from mesenchymal tissue and composed of varying degrees of adipose tissue, muscle and blood vessels. Renal AMLs (RAMLs) are the result of a sporadic event, and, in most of cases, the diagnosis is usually incidental, but hemorrhage and shock may be present. During pregnancy, the size of AMLs may increase and they may rupture, probably due to the high expression of hormone receptors, and the increase in maternal circulation and abdominal pressure. The authors present a case of a woman with ruptured RAML submitted to urgent endovascular treatment four days after giving birth by cesarean section.

Resumo

Angiomiolipomas (AMLs) são tumores benignos raros derivados do tecido mesenquimal, compostos em graus variados de tecido adiposo, muscular e de vasos sanguíneos. Os AMLs renais (AMLRs) resultam de um evento esporádico e, na maioria dos casos, o diagnóstico costuma ser fortuito, mas quadros de hemorragia e choque podem estar presentes. Durante a gestação, os AMLs podem aumentar de tamanho e romper, provavelmente pela alta expressão de receptores hormonais, e pelo aumento da circulação materna e da pressão abdominal. Os autores apresentam um caso de uma paciente com AMLR roto submetida a tratamento endovascular de urgência no quarto dia pós-operatório de uma cesariana.

Keywords

angiomyolipoma - kidney - therapeutic embolization - pregnancy complications - postpartum period

Palavras-chave

angiomiolipoma - rim - embolização terapêutica - complicações na gravidez - período pós-parto
 

  • References

  • 1 Palácios RM, Góes ASO, Albuquerque PC, Aguiar MFM, Ribeiro FRCM, Góes Junior AMO. Tratamento endovascular de angiomiolipoma renal por embolização arterial seletiva. J Vasc Bras 2012; 11: 324-328 . Doi: 10.1590/S1677-54492012000400013
    CrossrefPubMedSearch in Google Scholar
  • 2 Ao L, Ogasahara E, Okuda Y, Hirata S. Spontaneous rupture of renal angiomyolipoma during pregnancy. BMJ Case Rep 2017; 2017: bcr2016217284 . Doi: 10.1136/bcr-2016-217284
    CrossrefPubMedSearch in Google Scholar
  • 3 Góes Junior AMO, Jeha SAH, Salgado JRC. Embolização arterial superseletiva para tratamento de angiomiolipoma em paciente com rim único. J Vasc Bras 2016; 15 (02) 142-146 . Doi: 10.1590/1677-5449.005515
    CrossrefPubMedSearch in Google Scholar
  • 4 Antar A, Boyle A, Patel T. Angiomyolipoma of the adrenal gland: a case presentation and a review of adrenal lipomatous tumors. Urol Case Rep 2017; 12: 59-61 . Doi: 10.1016/j.eucr.2016.11.004
    CrossrefPubMedSearch in Google Scholar
  • 5 Boudaouara O, Kallel R, Smaoui W. , et al. Renal epithelioid angiomyolipoma: 2 cases report. Afr J Urol 2017; 23: 197-200 . Doi: 10.1016/j.afju.2016.10.002
    CrossrefPubMedSearch in Google Scholar
  • 6 Govednik-Horny C, Atkins M. Angiomyolipoma with vascular invasion during pregnancy. Ann Vasc Surg 2011; 25 (08) 1138.e9-1138.e13 . Doi: 10.1016/j.avsg.2011.05.023
    CrossrefPubMedSearch in Google Scholar
  • 7 Preece P, Mees B, Norris B, Christie M, Wagner T, Dundee P. Surgical management of haemorrhaging renal angiomyolipoma in pregnancy. Int J Surg Case Rep 2015; 7C: 89-92 . Doi: 10.1016/j.ijscr.2015.01.004
    CrossrefPubMedSearch in Google Scholar
  • 8 Flum AS, Hamoui N, Said MA. , et al. Update on the diagnosis and management of renal angiomyolipoma. J Urol 2016; 195 (4 Pt 1): 834-846 . Doi: 10.1016/j.juro.2015.07.126
    CrossrefPubMedSearch in Google Scholar
  • 9 Orywal AK, Zeile M, Brüning R, Gross AJ, Netsch C. Rupture of renal angiomyolipoma during childbirth. Urology 2015; 85 (04) e19-e20 . Doi: 10.1016/j.urology.2014.12.008
    CrossrefPubMedSearch in Google Scholar
  • 10 Gimeno Argente V, Bosquet Sanz M, Bonillo García MA, Gómez Pérez L, Pontones Moreno JL, Jiménez Cruz JF. Cirugía conservadora del angiomiolipoma renal bilateral durante el embarazo. Actas Urol Esp 2006; 30 (06) 633-637 . Doi: 10.1016/S0210-4806(06)73506-9
    CrossrefPubMedSearch in Google Scholar
  • 11 Pereira S, Martinho D, Rodrigues R. , et al. Rotura espontânea de angiomiolipoma renal. Acta Urol 2009; 26: 118
    PubMedSearch in Google Scholar
  • 12 Wang C, Li X, Peng L, Gou X, Fan J. An update on recent developments in rupture of renal angiomyolipoma. Medicine (Baltimore) 2018; 97 (16) e0497 . Doi: 10.1097/MD.0000000000010497
    CrossrefPubMedSearch in Google Scholar
  • 13 dos Santos MM, Proença SMS, Reis MI. , et al. Spontaneous rupture of renal angiomyolipoma during pregnancy. Rev Bras Ginecol Obstet 2014; 36 (08) 377-380 . Doi: 10.1590/SO100-720320140005019
    CrossrefPubMedSearch in Google Scholar
  • 14 Çetin C, Büyükkurt S, Demir C, Evrüke C. Renal angiomyolipoma during pregnancy: Case report and literature review. Turk J Obstet Gynecol 2015; 12 (02) 118-121 . Doi: 10.4274/tjod.32848
    CrossrefPubMedSearch in Google Scholar
  • 15 Bińkowska M, Debska M, Mazurek M, Słapa R, Debski R. Embolization of renal angiomyolipoma in pregnancy: case report. Ginekol Pol 2009; 80 (06) 449-452
    PubMedSearch in Google Scholar
  • 16 Shah J, Jones J, Miller MA, Patel U, Anson KM. Selective embolization of bleeding renal angiomyolipoma in pregnancy. J R Soc Med 1999; 92 (08) 414-415
    CrossrefPubMedSearch in Google Scholar
  • 17 Liu J, Meng T, Yang X, Zhao G, Li B. Spontaneous rupture of renal angiomyolipoma in the third trimester. Taiwan J Obstet Gynecol 2015; 54 (06) 788-790 . Doi: 10.1016/j.tjog.2015.10.016
    CrossrefPubMedSearch in Google Scholar
  • 18 Lewis EL, Palmer JM. Renal angiomyolipoma and massive retroperitoneal hemorrhage during pregnancy. West J Med 1985; 143 (05) 675-676
    PubMedSearch in Google Scholar
  • 19 Lim CH, Mulvin D. Embolisation of bleeding renal angiomyolipoma in pregnancy. Open J Urol 2011; 1: 25-27 . Doi: 10.4236/oju.2011.13007
    CrossrefPubMedSearch in Google Scholar
  • 20 Yanai H, Sasagawa I, Kubota Y. , et al. Spontaneous hemorrhage during pregnancy secondary to renal angiomyolipoma. Urol Int 1996; 56 (03) 188-191 . Doi: 10.1159/000282838
    CrossrefPubMedSearch in Google Scholar
  • 21 Ozkara H, Özkan B, Solok V. Management of renal abscess formation after embolization due to renal angiomyolipomas in two cases. Int Urol Nephrol 2006; 38 (3-4): 427-429 . Doi: 10.1007/s11255-005-0253-x
    CrossrefPubMedSearch in Google Scholar