What are the Risks of Angiomyolipoma?
Angiomyolipoma: What You Need to Know.
The major risk of an angiomyolipoma is that it ruptures and bleeds. The hemorrhage can be catastrophic and typically fast in onset and unpredictable. This typically occurs suddenly in patients without a prior diagnosis of angiomyolipoma. The angiomyolipomas that bleed tend to be large, greater than 4-5 cm in diameter. A patient may present with sudden abdominal pain or dizziness and loss of consciousness. Without prompt recognition, diagnosis, resuscitation, and treatment, the outcome can be deadly.
The chances of an angiomyolipoma bleeding increase significantly once it reaches the diameter of more than 4 cm. In general, a bleeding angiomyolipoma is a fairly uncommon diagnosis. Most angiomyolipomas are detected as small masses and they tend to stay small for many years, growing fairly slowly in most patients. The exceptions are patients with Tuberous Sclerosis Complex (TSC), a genetic condition that affects 20-30% of patients with angiomyolipoma.
The risk of angiomyolipoma rupturing during pregnancy is probably small but is thought to be increased as a result of the possibly higher rate of growth of AML during pregnancy under stimulation of estrogens. AML during pregnancy certainly poses a much more complex decision-making scenario given the need to achieve 3 goals: (1) treatment of AML, (2) safety of mother and (3) safety of the fetus.
Dr. Alex Shteynshlyuger is a board-certified urologist in NYC. He specializes in the treatment of men and women with kidney cysts, masses, renal cancer and angiomyolipoma (AML).