Clinical presentation, management, and outcome of patients with incidental renal angiomyolipoma in qatar.

OBJECTIVES Our study aimed to analyze the clinical presentation, management, and outcome of renal angiomyolipoma patients incidentally detected upon computed tomography (CT) examination. METHODS Between 2004 and 2008, all patients who underwent abdominal CT examination for any reason at the radiology department at Hamad General Hospital, Qatar were retrospectively reviewed. The diagnosis of renal angiomyolipoma was based on abdominal CT evaluation. Angiomyolipoma patients were followed-up by CT evaluation as per standard care for three years to observe any change in size and outcome. RESULTS A total of 13,115 patients were screened, of which 56 (40 females and 16 males) had renal angiomyolipoma. The mean age of patients was 52±13 years with 46% Qatar nationals. The majority (95%) of cases had unilateral tumors (52% right-sided and 43% left-sided). Twenty-six cases showed increase in tumor size and the median increase was 0.5cm (0.1-3.6). Surgical intervention was required in four (7%) cases with tumor size ≥4cm. The overall mortality on follow-up was 7%. The cause of death included metastasis, renal failure, hepatic failure and mesenteric thromboembolism. CONCLUSION Renal angiomyolipoma is an uncommon benign tumor with an overall prevalence of 0.4% in Qatar. It has characteristic clinical features and its recognition is often challenging for proper clinical diagnosis and treatment in asymptomatic patients. Asymptomatic patients need regular radiological surveillance. In contrast, surgical interventions are mainly required in symptomatic patients with increased tumor size (≥4cm). Timely diagnosis and treatment is necessary to avoid complications such retroperitoneal hemorrhage and renal impairment.