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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.
- Lymphangiomyomatosis

Radiographic Features:

- 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

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