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Angiomyolipoma (Tuberous Sclerosis)
Hamartomas containing fat, smooth muscle and blood vessels
small lesions not treated. Large and symptomatic lesions are resected or embolized
tumors may spontaneously bleed because of their vascular elements
Unlikely to bleed if < 4cm
- Tuberous Sclerosis. 80% of patients with TS have angiomyolipomas. <40% of patients with angiomyolipomas have tuberous sclerosis.
- Fat in lesion. The presence of fat in a renal lesion is virtually diagnostic of angiomyolipoma. Caveat: be sure that fat associated with a large mass is not trapped renal sinus or peripheral fat
- Predominance of blood vessels. Strong contrast enhancement. T2 weighted hyperintensity.
- Predominance of muscle.
- Do not calcify. If a lesion contains calcification consider something else, such as RCC.
- Angiography: tortous, irregular, aneurysmally dilated vessels seen in 3%. Presence depends on the amount of angiomatous tissue