Ультразвуковые особенности ангиомиолипом при туберозном склерозе у детей: КЛИНИЧЕСКИЙ СЛУЧАЙ

Эмилия Наумовна  Столова; Елена Владимировна  Синельникова; Наталья Викторовна  Марченко; Иван Александрович  Баулин; Екатерина Михайловна  Грызунова; Наталья Владимировна  Крашенинникова; Ульяна Анатольевна  Струпенева; Анастасия Вячеславовна  Синицына

doi:10.56871/

Ultrasound features of angiomiolipomas in tuberous sclerosis in children

CLINICAL CASE

Emilia N. Stolova Saint Petersburg State Pediatric Medical University https://orcid.org/0009-0008-0590-9906
Elena V. Sinelnikova Saint Petersburg State Pediatric Medical University
Natalya V. Marchenko Saint Petersburg State Pediatric Medical University
Ivan A. Baulin Saint Petersburg State Pediatric Medical University
Ekaterina M. Gryzunova Saint Petersburg State Pediatric Medical University
Natalya V. Krasheninnikova Saint Petersburg State Pediatric Medical University
Ulyana A. Strupeneva Saint Petersburg State Pediatric Medical University
Anastasiya V. Sinitsyna Saint Petersburg State Pediatric Medical University

Keywords:

angiomyolipomas of the kidneys kidney cysts tuberous sclerosis complication of angiomyolipoma chronic kidney disease ангиомиолипома почек кисты почек туберозный склероз осложнение ангиомиолипом хроническая болезнь почек

Abstract

This article describes the ultrasound features of kidney angiomiolipomas in children. Kidney angiomyolipomas, being benign neoplasms, can be detected both in isolation and as part of a genetically determined pathology, such as tuberous sclerosis. Sometimes angiomyolipomas can be isoechoic and not be visualized by ultrasound, which is due to the small amount of fatty tissue in the tumor. With tuberous sclerosis, not only angiomyolipomas can be detected in the kidneys, but also cystic changes. Sometimes cysts are the only renal manifestation of tuberous sclerosis, making diagnosis difficult. Currently, the diagnosis of tuberous sclerosis is based on a set of clinical diagnostic criteria. Complications of rapidly growing angiomiolipomas can include bleeding, chronic kidney disease up to the terminal stage. The article describes cases of visualization of isolated angiomiolipomas and cases of visualization of angiomiolipomas in tuberous sclerosis, describes the differences between them. Renal manifestations of tuberous sclerosis are not yet widely represented, so dynamic ultrasound monitoring can play a significant role in accumulating knowledge on this issue, assessing the effect of targeted therapy on angiomiolipomas growth inhibition and the incidence of complications.

Author Biography

Emilia N. Stolova, Saint Petersburg State Pediatric Medical University

Cand. Sci. (Med.), Associate Professor of the Department of Radiation Diagnostics and Biomedical Imaging of the Faculty of Surgery and Advanced Medical Education

References

1. Khaddam S., Gulati S. Spectrum of presentations and management strategies in renal angiomyolipoma. J Kidney Cancer VHL. 2022;9(1):42–47. https://doi.org/10.15586/jkcvhl.v9i1.221.

2. Bhatt J.R., Richard P.O., Kim N.S., Finelli A., Manickavachagam K., Legere L., Evans A., Pei Y., Sykes J., Jhaveri K., Jewett M.A.S. Natural history of renal Angiomyolipoma (AML): Most patients with large AMLs >4 cm can be offered active surveillance as an initial management strategy. Eur Urol. 2016;70(1):85–90. https://doi.org/10.1016/j.eururo.2016.01.048.

3. Jinzaki M., Silverman S.G., Akita H., Nagashima Y., Mikami S., Oya M. Renal angiomyolipoma: a radiological classification and update on recent developments in diagnosis and management. Abdom Imaging. 2014;39(3):588–604. https://doi.org/10.1007/s00261-014-0083-3.

4. Lane B.R., Aydin H., Danforth T.L., Zhou M., Remer E.M., Novick A.C., Campbell S.C. Clinical correlates of renal angiomyolipoma subtypes in 209 patients: classic, fat poor, tuberous sclerosis associated and epithelioid. J Urol. 2008;180(3):836–843. https://doi.org/10.1016/j.juro.2008.05.041.

5. C толова Э.Н., Синельникова Е.В., Крашенинникова Н.В., Варламова Н.Н., Синицына А.В. Возможности ультразвукового исследования в дифференциальной диагностике объемных образований почек. Визуализация в медицине. 2022;4(3):3–12. Stolova E.N., Sinelnikova E.V., Krasheninnikova N.V., Varlamova N.N., Sinitsyna A.V. Possibilities of ultrasound in differential diagnosis of renal mass. Visualization in Medicine. 2022;4(3):3–12. (In Russian).

6. Jinzaki M., Silverman S.G., Akita H., Nagashima Y., Mikami S., Oya M. Renal angiomyolipoma: a radiological classification and update on recent developments in diagnosis and management. Abdom Imaging. 2014;39(3):588–604. https://doi.org/10.1007/s00261-014-0083-3.

7. Seyam R.M., Alkhudair W.K., Kattan S.A., Alotaibi M.F., Alzahrani H.M., Altaweel W.M. The risks of renal angiomyolipoma: reviewing the evidence. J Kidney Cancer VHL. 2017;4(4):13–25. https://doi.org/10.15586/jkcvhl.2017.97.

8. Varshney B., Vishwajeet V., Madduri V., Chaudhary G.R., Elhence P.A. Renal angiomyolipoma with epithelial cyst. Autops Case Rep. 2021;11:e2021308. https://doi.org/10.4322/acr.2021.308.

9. Vos N., Oyen R. Renal angiomyolipoma: The good, the bad, and the ugly. J Belg Soc Radiol. 2018;102(1):41. https://doi.org/10.5334/jbsr.1536.

10. Dixon B.P., Hulbert J.C., Bissler J.J. Tuberous sclerosis complex renal disease. Nephron Exp Nephrol. 2011;118(1):e15–20. https://doi.org/10.1159/0003208910.

11. Babol-Pokora K., Bielska M., Bobeff K., Jatczak-Pawlik I., Borkowska J., Kotulska K., Joźwiak S., Młynarski W., Trelińska J. A multistep approach to the genotype-phenotype analysis of Polish patients with tuberous sclerosis complex. Eur J Med Genet. 2021;64(10):104309. https://doi.org/10.1016/j.ejmg.2021.104309.

12. Curatolo P., Bombardieri R., Jozwiak S. Tuberous sclerosis. Lancet. 2008;372(9639):657–668. https://doi.org/10.1016/S0140-6736(08)61279-9.

13. Limavady A., Marlais M. The extent of kidney involvement in paediatric tuberous sclerosis complex. Pediatr Nephrol. 2024;39(10):2927–2937. https://doi.org/10.1007/s00467-024-06417-2.

14. Flum A.S., Hamoui N., Said M.A., Yang X.J., Casalino D.D., Mc Guire B.B., Perry K.T., Nadler R.B. Update on the diagnosis and management of renal angiomyolipoma. J Urol. 2016;195(4 Pt 1):834–846. https://doi.org/10.1016/j.juro.2015.07.126.

15. Sooriakumaran P., Gibbs P., Coughlin G., Attard V., Elmslie F., Kingswood C., Taylor J., Corbishley C., Patel U., Anderson C. Angiomyolipomata: challenges, solutions, and future prospects based on over 100 cases treated. BJU Int. 2010;105(1):101–106. https://doi.org/10.1111/j.1464-410X.2009.08649.x.

16. Portocarrero L.K.L., Quental K.N., Samorano L.P., Oliveira Z.N.P., Rivitti-Machado M.C.D.M. Tuberous sclerosis complex: review based on new diagnostic criteria. An Bras Dermatol. 2018;93(3):323–331. https://doi.org/10.1590/abd1806-4841.20186972.

17. Jinzaki M., Silverman S.G., Akita H., Nagashima Y., Mikami S., Oya M. Renal angiomyolipoma: a radiological classification and update on recent developments in diagnosis and management. Abdom Imaging. 2014;39(3):588–604. https://doi.org/10.1007/s00261-014-0083-3.

18. Dong A., Yang Q., Hua M., Cheng C., Zuo C. Lipid-poor renal angiomyolipoma mimicking renal cell carcinoma on 68 Ga-FAPI-04 PET/CT. Clin Nucl Med. 2022;47(11):991–993. https://doi.org/10.1097/RLU.0000000000004297.

19. Guo Y., Kapoor A., Cheon P., So A.I., Lattouf J.B., Jamal M. Canadian Urological Association best practice report: Diagnosis and management of sporadic angiomyolipomas. Can Urol Assoc J. 2020;14(11):E527–E536. https://doi.org/10.5489/cuaj.6942.

20. Ascenti G., Zimbaro G., Mazziotti S., Gaeta M., Settineri N., Scribano E. Usefulness of power Doppler and contrast-enhanced sonography in the differentiation of hyperechoic renal masses. Abdom Imaging. 2001;26(6):654–660. https://doi.org/10.1007/s00261-001-0025-8.

21. Habibollahi P., Sultan L.R., Bialo D., Nazif A., Faizi N.A., Sehgal C.M., Chauhan A. Hyperechoic renal masses: differentiation of angiomyolipomas from renal cell carcinomas using tumor size and ultrasound radiomics. Ultrasound Med Biol. 2022;48(5):887–894. https://doi.org/10.1016/j.ultrasmedbio.2022.01.011.

22. Schieda N., Davenport M.S., Pedrosa I., Shinagare A., Chandarana H., Curci N., Doshi A., Israel G., Remer E., Wang J., Silverman S.G. Renal and adrenal masses containing fat at MRI: Proposed nomenclature by the society of abdominal radiology disease-focused panel on renal cell carcinoma. J Magn Reson Imaging. 2019;49(4):917–926. https://doi.org/10.1002/jmri.26542.

23. Hélénon O., Merran S., Paraf F., Melki P., Correas J.M., Chrétien Y., Moreau J.F. Unusual fat-containing tumors of the kidney: a diagnostic dilemma. Radiographics. 1997;17(1):129–144. https://doi.org/10.1148/radiographics.17.1.9017804.

24. Bissler J.J., Batchelor D., Kingswood J.C. Progress in tuberous sclerosis complex renal disease. Crit Rev Oncog. 2022;27(2):35–49. https://doi.org/10.1615/Crit Rev Oncog.2022042857.

Ultrasound features of angiomiolipomas in tuberous sclerosis in children: CLINICAL CASE. (2026). Visualization in Medicine, 7(4), 46-54. https://doi.org/10.56871/

Download Citation

How to Cite