Angiomyolipoma (Tuberous Sclerosis)

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Hamartomas containing fat, smooth muscle and blood vessels

Treatment:

small lesions not treated. Large and symptomatic lesions are resected or embolized

Complications:

tumors may spontaneously bleed because of their vascular elements

Unlikely to bleed if < 4cm

Associations:

- Tuberous Sclerosis. 80% of patients with TS have angiomyolipomas. <40% of patients with angiomyolipomas have tuberous sclerosis.
- Lymphangiomyomatosis

Radiographic Features:

- Fat in lesion. The presence of fat in a renal lesion is virtually diagnostic of angiomyolipoma. Caveat: be sure that fat associated with a large mass is not trapped renal sinus or peripheral fat
- Predominance of blood vessels. Strong contrast enhancement. T2 weighted hyperintensity.
- Predominance of muscle.
- Do not calcify. If a lesion contains calcification consider something else, such as RCC.
- Angiography: tortous, irregular, aneurysmally dilated vessels seen in 3%. Presence depends on the amount of angiomatous tissue