Unclamped Nephron-Sparing Surgery With Preoperative Selective Arterial Embolization For The Management Of Bilateral Giant Renal Angiomyolipomas

Angiomyolipoma (AML) is known as a type of benign renal tumor that has a propensity to grow over time and might cause local complications. Considering the benign nature of these lesions, renal-preserving treatments are favored when tumor size becomes > 4 cm because the risk of spontaneous life-threatening hemorrhage is increased.We report on a patient with bilateral multifocal giant AMLs with the largest diameter of 38.2 cm in the left kidney and 9.5 cm in the right kidney who was treated successfully with preoperative selective arterial embolization and nephron-sparing surgery without hilar clamping. The intraoperative bleeding volume was acceptable and the patient was discharged uneventfully with normal renal function.Partial nephrectomy and preoperative selective arterial embolization offers the preservation of renal function with acceptable complications and might be a safe and effective treatment modality for this type of rare bilateral giant renal AML. (C) 2014 Elsevier Inc. All rights reserved.