D F W Maclean1, R Sultana2, R Radwan2, L McKnight3, J Khastgir2. 1. Department of Urology, Morriston Hospital, Swansea SA6 6NL, UK. Electronic address: dfwmaclean@doctors.org.uk. 2. Department of Urology, Morriston Hospital, Swansea SA6 6NL, UK. 3. Department of Radiology, Morriston Hospital, Swansea SA6 6NL, UK.
Abstract
AIM: To investigate the natural history and rationalize follow-up of renal angiomyolipomas (AMLs). MATERIALS AND METHODS: A prospectively gathered radiology database was scrutinized to identify patients with renal AMLs over a 3 year period (January 2006 to December 2008). Radiological investigations were examined to identify those AMLs exhibiting change during surveillance. RESULTS: A total of 135 patients were identified. Mean age at first detection was 49.6 years and patients were followed up for a median 21.8 months (6-85.3 months). Small AMLs (≤20 mm) were less likely to grow than their larger counterparts [odds ratio 13.3, confidence interval (95% CI) 1.4-123.9, p = 0.02] and exhibited a slower growth rate (0.7 versus 9.2 mm/year). Patients with AMLs that increased in size were significantly younger (median age 43 versus 52 years, p < 0.001). Multiple AMLs or those associated with genetic conditions grew at a significantly greater rate (3 versus 0.1 mm/year, p < 0.001). AMLs with a large extra-renal component are less reliably measured on ultrasound (median error 7 versus 1 mm, p < 0.001). CONCLUSION: This is the first study with the primary purpose to investigate growth of small AMLs (≤20 mm). Small, solitary AMLs (≤20 mm) do not require follow-up due to their low probability of growth. Patients with multiple AMLs and younger patients require closer monitoring due to their comparatively greater AML growth rate. Ultrasound-detected AMLs with an extra-renal component may require computed tomography (CT) to confirm their size.
AIM: To investigate the natural history and rationalize follow-up of renal angiomyolipomas (AMLs). MATERIALS AND METHODS: A prospectively gathered radiology database was scrutinized to identify patients with renal AMLs over a 3 year period (January 2006 to December 2008). Radiological investigations were examined to identify those AMLs exhibiting change during surveillance. RESULTS: A total of 135 patients were identified. Mean age at first detection was 49.6 years and patients were followed up for a median 21.8 months (6-85.3 months). Small AMLs (≤20 mm) were less likely to grow than their larger counterparts [odds ratio 13.3, confidence interval (95% CI) 1.4-123.9, p = 0.02] and exhibited a slower growth rate (0.7 versus 9.2 mm/year). Patients with AMLs that increased in size were significantly younger (median age 43 versus 52 years, p < 0.001). Multiple AMLs or those associated with genetic conditions grew at a significantly greater rate (3 versus 0.1 mm/year, p < 0.001). AMLs with a large extra-renal component are less reliably measured on ultrasound (median error 7 versus 1 mm, p < 0.001). CONCLUSION: This is the first study with the primary purpose to investigate growth of small AMLs (≤20 mm). Small, solitary AMLs (≤20 mm) do not require follow-up due to their low probability of growth. Patients with multiple AMLs and younger patients require closer monitoring due to their comparatively greater AML growth rate. Ultrasound-detected AMLs with an extra-renal component may require computed tomography (CT) to confirm their size.
Authors: Jarmila Kruseová; Barbora Gottfriedová; Andrea Zichová; Karel Švojgr; Petr Hošek; Aleš Lukš; Martin Kynčl; Tomáš Eckschlager Journal: Clin Epidemiol Date: 2021-08-11 Impact factor: 4.790
Authors: Katharina Maria Bretterbauer; Dean Markić; Daniela Colleselli; Stephan Hruby; Ahmed Magdy; Günter Janetschek; Michael Josef Mitterberger Journal: Case Rep Urol Date: 2015-02-26
Authors: J L H Ruud Bosch; Francis Vekeman; Mei Sheng Duh; Maureen Neary; Matthew Magestro; Jonathan Fortier; Paul Karner; Raluca Ionescu-Ittu; Bernard A Zonnenberg Journal: Int Urol Nephrol Date: 2018-01-15 Impact factor: 2.370