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Title: The scintigraphic pattern of renal angiomyolipoma

Abstract

The patterns of renal and gallium scintigraphy in a patient with renal angiomyolipoma are presented. Renal study with Tc-99m DTPA demonstrated a photopenic area in the flow and delayed images. Ga-67 citrate imaging did not show any evidence of increased activity. Although this pattern is also seen in renal cysts, scintigraphy seems to be valuable in the evaluation of angiomyolipoma. It helps differentiate it from renal carcinoma or renal abscess (which may be gallium avid), especially when the tumor is characterized by a paucity of adipose tissue and complicated by hemorrhage, in which case CT and ultrasonographic patterns are not diagnostic.

Authors:
; ;  [1]
  1. (SUNY, Stony Brook, NY (USA))
Publication Date:
OSTI Identifier:
6976324
Resource Type:
Journal Article
Resource Relation:
Journal Name: Clinical Nuclear Medicine; (USA); Journal Volume: 15:3
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; KIDNEYS; NEOPLASMS; DIAGNOSIS; ABSCESSES; ADIPOSE TISSUE; CITRATES; DTPA; GALLIUM 67; ISOMERIC NUCLEI; PATIENTS; SCINTISCANNING; TECHNETIUM 99; UROGENITAL SYSTEM DISEASES; AMINO ACIDS; ANIMAL TISSUES; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; CARBOXYLIC ACID SALTS; CARBOXYLIC ACIDS; CHELATING AGENTS; CONNECTIVE TISSUE; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; DRUGS; ELECTRON CAPTURE RADIOISOTOPES; GALLIUM ISOTOPES; HOURS LIVING RADIOISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; ORGANIC ACIDS; ORGANIC COMPOUNDS; ORGANS; PATHOLOGICAL CHANGES; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOPROTECTIVE SUBSTANCES; TECHNETIUM ISOTOPES; TISSUES; YEARS LIVING RADIOISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Jaikishen, P., Oster, Z.H., and Atkins, H.L. The scintigraphic pattern of renal angiomyolipoma. United States: N. p., 1990. Web. doi:10.1097/00003072-199003000-00011.
Jaikishen, P., Oster, Z.H., & Atkins, H.L. The scintigraphic pattern of renal angiomyolipoma. United States. doi:10.1097/00003072-199003000-00011.
Jaikishen, P., Oster, Z.H., and Atkins, H.L. Thu . "The scintigraphic pattern of renal angiomyolipoma". United States. doi:10.1097/00003072-199003000-00011.
@article{osti_6976324,
title = {The scintigraphic pattern of renal angiomyolipoma},
author = {Jaikishen, P. and Oster, Z.H. and Atkins, H.L.},
abstractNote = {The patterns of renal and gallium scintigraphy in a patient with renal angiomyolipoma are presented. Renal study with Tc-99m DTPA demonstrated a photopenic area in the flow and delayed images. Ga-67 citrate imaging did not show any evidence of increased activity. Although this pattern is also seen in renal cysts, scintigraphy seems to be valuable in the evaluation of angiomyolipoma. It helps differentiate it from renal carcinoma or renal abscess (which may be gallium avid), especially when the tumor is characterized by a paucity of adipose tissue and complicated by hemorrhage, in which case CT and ultrasonographic patterns are not diagnostic.},
doi = {10.1097/00003072-199003000-00011},
journal = {Clinical Nuclear Medicine; (USA)},
number = ,
volume = 15:3,
place = {United States},
year = {Thu Mar 01 00:00:00 EST 1990},
month = {Thu Mar 01 00:00:00 EST 1990}
}
  • Angiomyolipomas are benign tumors composed of blood vessels, smooth muscle, and mature, adult-type fat cells with predominance of one of the three elements. These tumors, therefore, represent a true hamartoma. Previously, the diagnosis was rarely made preoperatively, and surgical resection of the kidney was done. This would have presented a management dilemma for our patient, who was seen for hematuria and a solid mass in her solitary kidney. Ultrasonography and computerized tomography can provide a specific diagnosis, and more conservative therapy can thus be instituted. 6 references, 2 figures.
  • A case is described of a woman 10 weeks pregnant who had severe bleeding, secondary to a renal angiomyolipoma (AML), that was treated with embolization. Subsequent pregnancy was uneventful and she delivered a normal female infant 28 weeks after the procedure. One month after delivery, liquefaction of the AML occurred, which eventually required surgical drainage. We review and discuss AML during pregnancy, its management and post-embolization complication000.
  • We report a case of a large perinephric pseudoaneurysm due to spontaneous rupture of renal angiomyolipoma, occluded by percutaneous thrombin injection under ultrasound guidance in a young woman affected by tuberous sclerosis.
  • Purpose. To study the feasibility of percutaneous radiofrequency ablation (RFA) of large angiomyolipomas (AMLs) using saline-cooled electrodes. Materials and Methods. Institutional Review Board approval for the study was received. Four patients (all female, age range 33-67 years) with large AMLs (maximal axis 6.1-32.4 cm) not suitable for embolotherapy or surgery consented to a trial of RFA. Procedures were performed under computerized tomographic guidance using 14G saline-infused electrodes. Two ablations (diameter 4-7 cm) were undertaken in each patient. Variables studied were technical success, treatment safety, alteration of tumor consistency, tumor size, effect on renal function, and medium-term freedom from haemorrhage. Results.more » All four patients underwent successful RFA without any intraprocedural complications. There has been no haemorrhage, or new renal specific symptom, during a minimum 48-month period, and normal renal function has been normal. On follow-up radiological imaging, the tumors have become fattier with involution of the soft-tissue elements (soft tissue-to-total tumor ratio decreased mean [range] of 0.26 [0.14-0.48] to 0.17 [0.04-0.34] U; p = 0.04 [paired Student t test]). Further evidence of treatment effect was the development of a capsule around the ablation zone, but there was no change in overall tumor volume (mean [range] 1,120 [118-2,845] to 1150 [90-3,013] ml; p = 1 [paired Student t test]). Conclusion. RFA of large AMLs is technically feasible using saline-infused electrodes. The soft-tissue elements decreased in volume; the tumors become fattier; and there has been no renal haemorrhage during a 48-month period.« less
  • Transcatheter embolization of renal angiomyolipomas is a routinely performed, nephron-sparing procedure with a favorable safety profile. Complications from this procedure are typically minor in severity, with postembolization syndrome the most common minor complication. Abscess formation is a recognized but uncommon major complication of this procedure and is presumably due to superinfection of the infarcted tissue after arterial embolization. In this case report, we describe the formation of a renoduodenal fistula after embolization of an angiomyolipoma, complicated by intracranial abscess formation and requiring multiple percutaneous drainage procedures and eventual partial nephrectomy.