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Angiolipoma of the kidney
Last reviewed: 04.07.2025
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Renal angiolipoma is a benign mesenchymal tumor consisting of smooth muscle fibers, thick-walled blood vessels, and mature adipose tissue in varying proportions. There are two forms of angiomyolipoma: isolated (90% of cases) and associated with tuberous sclerosis (Bourneville-Pringle disease) (10% of cases). In tuberous sclerosis, tumors are usually multiple and bilateral.
Causes renal angiolipomas
Little is known about the pathogenesis of angiomyolipoma: it remains unclear whether the isolated form of the disease is a congenital malformation (hamartoma) or a true tumor.
Despite its benign nature, angiomyolipoma is capable of locally invasive growth with the formation of tumor venous thrombosis (1% of observations). Observations of angiomyolipoma metastases to regional lymph nodes have been described.
Symptoms renal angiolipomas
Symptoms of renal angiolipoma depend on the size of the angiomyolipoma. As a rule, the symptomatic course characterizes tumors larger than 4 cm.
In addition to pain (27.3%), palpable tumor (23.1%) and hematuria (3%), 10% of patients experience spontaneous ruptures of angiomyolipoma with the development of retroperitoneal bleeding, often accompanied by the picture of an “acute abdomen”.
This tumor is characterized by a specific radiological picture due to the high fat content and rich vascularization (hyperechoic volumetric formation on ultrasound, hypodense and richly vascularized on CT with intravenous bolus contrast).
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What tests are needed?
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Treatment renal angiolipomas
Treatment of renal angiolipoma depends on the form, size and clinical picture of the angiomyolipoma. Isolated asymptomatic tumors up to 4 cm in the largest dimension are subject to observation, in all other cases resection of the kidney is indicated.
Forecast
Renal angiolipoma has a good prognosis.
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