Psödoanevrizmalı renal anjiyomiyolipomda selektif embolizasyon

Yıl 2025, Cilt: 18 Sayı: 1, 219 - 225, 01.01.2025

Alper Şimşek , Mesut Berkan Duran , Kürşat Küçüker , Sinan Çelen , Yusuf Özlülerden , Mehmet Kırdar , Ömer Levent Tuncay

https://doi.org/10.31362/patd.1448301

Öz

Anjiyomiyolipomalar genellikle tesadüfen teşhis edilir ve genellikle semptomsuzdur. Özellikle, 4 cm'den
büyük lezyonlar semptomatik olma eğilimindedir ve yaşamı tehdit eden retroperitoneal veya üriner kanama
ile ortaya çıkabilir. Anjiyomiyolipomaların tipik komplikasyonu intrarenal veya perinefratik kanamadır, ancak bir
psödoanevrizma görünüşü olağandışıdır. Bu çalışmada anjiyomiyolipomanın olağan dışı komplikasyonu olan
psödoanevrizmalı hastayı sunmayı amaçladık. Bu makalede, sol yan ağrısı ve hematüri şikayetleri ile başvuran
ve böbrekteki psödoanevrizmatik anjiyomiyolipoma nedeniyle seçici arteriyel embolizasyon geçiren bir hasta
sunulmaktadır. Hastanın anjiyografisi, sol böbreğin üst ve orta segmentlerini dolduran büyük bir hipervasküler
kitleyi göstermiştir. Kütlede bir subsegmental dal kökenli psödoanevrizmal dolgu gözlemlenmiştir. Seçici
anjioembolizasyon sonrasında, kitlede 5 yıllık takipte küçülme olduğu gözlemlenmiştir. Anjiyomiyolipomaların
psödoanevrizma ile bir araya gelmesi nadirdir. Büyük kanama ve yırtılma önlemek için güvenli, etkili ve minimal
invaziv seçici arteriyel embolizasyon güvenle uygulanabilir.

Anahtar Kelimeler

Anjiyomiyolipoma, psödoanevrizma, retroperitoneal kanama, selektif anjiyografi

Selective embolization in renal angiomyolipoma with pseudoaneurysm

Öz

Angiomyolipomas are usually diagnosed incidentally and are usually asymptomatic. Dysmorphic blood vessels in
angiomyolipomas usually do not contain an internal elastic lamina, so bleeding risks are high. Particularly, lesions
larger than 4 cm have a tendency to become symptomatic and can present with life-threatening retroperitoneal
or urinary bleeding. Although intrarenal or perinephric bleeding is the usual complication of angiomyolipomas,
a pseudoaneurysm appears unusual. In this case, we aimed to present a patient with pseudoaneurysm, an
unusual complication of angiomyolipoma. In this article, a patient who presented with complaints of left flank pain
and hematuria and who underwent selective arterial embolization due to pseudoaneurysmatic angiomyolipoma
in the left kidney is presented. The patient's angiography showed a large hypervascular mass filling the upper
and middle segments of the left kidney. A pseudoaneurysmal filling originating from a subsegmental branch
was observed in the mass. The patient underwent selective embolization. After 5 years of follow-up, the mass
was observed to shrink. Angiomyolipomas are benign tumors, but especially symptomatic masses larger than
4 cm and especially masses with aneurysms larger than 5 mm can cause life-threatening retroperitoneal
hemorrhages. Coexistence of angiomyolipomas with pseudoaneurysm is rare, especially. Safe, effective and
minimally invasive selective arterial embolization can be safely performed to prevent massive bleeding and
rupture.

Anahtar Kelimeler

Angiomyolipoma, pseudoaneurysm, retroperitoneal hemorrhage, selective angiography

Kaynakça

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