Forms and features of kidney angiolipoma methods of tumor treatment and diagnosis

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The kidneys play a major role in the work of the urinary system, pumping blood, cleansing it of harmful substances. Having heard the diagnosis of “angiomyolipoma” (left kidney, right or two organs at the same time), the patient usually asks several questions: what is it and how to treat angiomyolipoma in the right kidney, is it possible to cure it.

This disease is successfully detected and completely eliminated with the help of modern diagnostics and treatment. The methods by which the therapy is carried out are selected depending on the shape, stage and size of the angioma.

Angiomyolipoma: what is it

Angiomyolipoma (AML) is a special type of renal tumor, the most common benign neoplasm. It consists of cells of adipose tissue, smooth muscles, and blood vessels. Usually, the size of an angiolipoma is 0,1-2 cm, the maximum is 20 cm. A fast-growing angiomyolipoma poses a danger to human health and life. The tumor can affect the renal vein and lymph nodes in the kidneys.

There is another variant of a benign tumor – kidney angioma. It differs in structure. What is kidney angioma? It is a benign kidney tumor consisting of altered blood vessels or lymphatic capillaries. The proliferation of tissues leads to dysfunction of the organ.

In women, this pathology is more common than in men. Angiolipomas more often appear in the fairer sex between the ages of 30 and 50. In men, they are usually diagnosed after 50. The neoplasm is often localized on the one hand, it is the cause of 75% of all visits to the doctor. The disease is usually found in the right kidney, which is explained by the peculiarities of the human anatomical structure.

Angiomyolipoma has an abbreviated version of the name – “angiolipoma”, both terms mean the same disease.

Forms and their features

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The disease has two forms, differing in the nature of its occurrence:

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Congenital

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Kidney angioma is inherited. The condition occurs against the background of tuberous sclerosis (a rare genetic pathology), which leads to the appearance of small benign tumors in various tissues and organs. The formation of angiomyolipoma is focal, occurs simultaneously in the right and left kidney. Cells of a benign neoplasm do not degenerate into cancerous ones, and metastases are not formed.

Sporadic

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The second type of angiomyolipoma is more common, in more than 80% of cases. This is an acquired disease. Factors contributing to the onset of pathology are pregnancy, menopause, diseases of the urinary system in acute and chronic form, angiofibromas, endocrine disorders. Isolated education occurs on one side.

According to the composition of the tumor, 2 types of the disease are distinguished:

  • a typical angiomyolipoma consists of all types of tissues characteristic of a classic angiolipoma,
  • an atypical neoplasm does not include adipose tissue, which is found on histological examination. This fact complicates diagnostic measures – the tumor looks like a malignant one.

Causes

The exact reasons for the appearance of angiolipoma in the kidney have not been established. Scientists put forward only assumptions about the occurrence of the disease.

The main reason is considered to be hormonal changes in a woman’s body that occur during pregnancy. The body produces progesterone, estrogen. They act as provocateurs of tumor growth.

Other reasons why there is a kidney angioma:

  • genetic disease
  • congenital anomaly
  • inflammatory processes in the kidneys,
  • tumors of other organs,
  • endocrine diseases.

Possible complications

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Is renal angiomyolipoma life threatening? Neoplasm leads to various consequences and can pose a real threat to human health.

Tumor tissues grow unevenly. The vessels associated with the neoplasm grow more slowly than muscle tissue; they rupture when stretched. Due to the rupture, severe bleeding occurs, which leads to hemorrhagic shock, peritonitis.

Possible reasons for rupture of blood vessels can also be an increased need for neoplasm in oxygen and an increase in the intensity of blood circulation. The load on the vessels increases, there is a risk of aneurysm.

The rapid increase in size of angiolipoma can lead to rupture of the renal parenchyma. There is also a risk of malignant degeneration of the tumor.

The consequences of the disease for the body:

  • displacement of adjacent organs,
  • disruption of the urinary system,
  • the formation of blood clots in blood vessels,
  • tumor tissue necrosis,
  • impaired liver function.

Symptoms of kidney angiolipoma

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The size of the kidney tumor determines the symptoms and course of angiomyolipoma. Small neoplasms (up to 4 cm) usually do not appear in any way. It is impossible to detect angiolipoma at the initial stage independently, without the help of medical equipment, since the patient does not have any unpleasant sensations. Asymptomatic course is observed in 80% of patients.

As the tumor develops, its size increases and typical symptoms appear. Angiomyolipoma of the right or left kidney is characterized by the following manifestations:

  • pain in the lower back,
  • jumps in blood pressure,
  • general malaise, fainting,
  • renal colic,
  • dizziness,
  • pale skin
  • traces of blood in urine,
  • discomfort in the abdominal cavity,
  • on palpation, a seal is found.

Diagnostics

Pathology is detected using various studies. Analyzes and special equipment can diagnose angiolipoma even at the initial stage; for this, several different diagnostic methods are used.

To make the correct diagnosis, prescribe treatment, an examination is carried out:

  • Ultrasound. Ultrasound examination is the most common. This is due to the availability of equipment. The examination shows the presence of a tumor on the kidney with a size of 5 cm. But the nature of the neoplasm cannot be established.
  • MRI. This method allows you to consider the angiolipoma on the kidney in different planes.
  • MSCT. An accurate and objective way of diagnosing. The size of the angiomyolipoma, the presence of germination into neighboring organs are determined. Also, during computed tomography, the degree of kidney damage is assessed.
  • Angiography. X-ray examination of blood vessels using the introduction of a contrast agent. At the same time, the features of the blood supply to the tumor are studied, which is necessary for differential diagnosis, and also allows you to determine the treatment.
  • Biopsy and histological analysis. Research is done to determine the type of tumor. For this, the cells of the neoplasm are taken by puncture.

Treatment of kidney angiolipoma

Treatment of the disease includes various tactics and methods and depends on the stage of development of angiomyolipoma.

Small tumors, asymptomatic and accidentally discovered during examinations, do not require treatment. For some time, observational tactics are used – the condition is simply controlled by a doctor. The patient undergoes ultrasound or MSCT once a year to monitor the state of the tumor.

Conservative treatment

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To limit the size of the formation and stop tumor growth, drug therapy is used. The course of taking medications can last up to 1 year. Medicines in the treatment of kidney angiomyolipoma are not effective enough. Many doctors do not consider their reception expedient, since it is impossible to cure the neoplasm (achieve complete disappearance of the tumor) with their help. Cytostatic drugs are used temporarily, as a means of preparation for surgery.

Surgical intervention

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These treatments for renal angiolipoma include surgery with the least tissue trauma.

Ablation

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Destruction of tumor tissues and vessels through various physical influences: radio waves, cold, laser. The procedure stops the growth of the neoplasm, eliminates the need for surgical intervention.

Embolization

The method allows you to preserve the functionality of the organ and destroy the tumor by injecting blocking drugs into the vessels feeding it. This operation is the safest, and positive results are observed in most cases.

Laparoscopy

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Kidney angioma is removed through a minimal incision in the skin and peritoneum. The procedure allows you to preserve the organ and its functionality.

Abdominal surgery

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This method is considered the most radical and only treatment for large angiolipomas. The indications for surgical intervention are severe pain and rapid growth of the neoplasm.

The nature of the surgical intervention is determined by the size, course of the disease. Small tumors without bleeding undergo resection (amputation of the formation and part of the organ) and enucleation (excision of only the angioma). Complete removal of the affected kidney with angiomyolipoma is carried out in case of organ failure and tumor size more than 7 cm.

Forecast

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Angiomyolipoma is classified as a benign tumor. First, conservative treatment is carried out. If it does not give results, an operation is scheduled. After surgical treatment, patients quickly recover and lead a full life.

If angiomyolipoma is left untreated, it can lead to irreversible consequences for human health.

  • With an increase in the size of the angiomyolipoma, adjacent organs are squeezed, their functionality decreases.
  • There is a risk of rupture of blood vessels and dangerous bleeding, from which peritonitis occurs.
  • Abundant blood loss often ends with the death of the patient.
  • When the kidney itself stops working, necrosis occurs.

Timely detection and treatment of the tumor is a prerequisite for complete recovery.

If you suspect an angioma, the appearance of symptoms of the disease, you should contact a specialist for a diagnosis. The method of treatment is chosen depending on the characteristics of the course of the disease.

Progressive tumors require surgical intervention, and the removal method can be minimally invasive or radical. Timely treatment of the neoplasm will help get rid of the disease.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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