Selective Arterial Embolization of Giant Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex Using Particular and Liquid Embolic Agents

Abstract

Renal angiomyolipoma (AML) is a benign hamartomatous tumor that is sometimes associated with the tuberoussclerosis complex. We report a 23-year-old man who presented with acute abdominal pain and hematuria.Computed tomography (CT) revealed large heterogeneous right renal mass of 17×13×13-cm diameter,consistent with AML, and acute and subacute hemorrhages. Digital subtraction angiography revealed massivetumor vascularization and multiple aneurysms associated with right renal artery branches. First, polyvinylalcohol particles were used for the selective embolization of AML. Then, N-butyl cyanoacrylate (glue) mixedwith lipiodol in a 1:3 ratio was injected for the permanent embolization of AML. CT scan revealed 59%reduction in size at 5 months after embolization. This case illustrates the selective embolization of giant renalAML with the combination of particular and liquid embolic agents with a significant reduction in size duringthe follow-up period.