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What should be done about a kidney lipoma?

This article, written by a team of urologists and surgeons from our clinic, aims to inform patients who have encountered a renal angiomyolipoma about the dangers of this condition, as well as modern methods of its diagnosis and treatment.

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Lipoma of the kidney

The diagnosis of "renal angiomyolipoma" comes as an unpleasant surprise to anyone. Imagine during a routine check-up or simply visiting a clinic with mild lower back pain, leaving the ultrasound room with the conclusion of "kidney tumor." Proving that this tumor is benign still needs to be done.

Even worse, the presence of an angiomyolipoma poses the risk of bleeding, tumor rupture,and often, lower back pain.

A renal angiomyolipoma is a benign tumor composed of fatty tissue and transformed blood vessels and epithelial cells. It often has small dimensions, but there are also large and even huge lipomas capable of invading the renal vein or, rarely, the inferior vena cava.

"Just because a tumor is called benign doesn't mean it can't seriously harm health."

It's important to know!

Angiomyolipoma has a particular characteristic: its blood vessels are defective and prone to forming aneurysms, which can rupture without any apparent cause. This factor compels us to closely monitor the patient and recommend surgical intervention as the size increases.

What makes lipoma dangerous?


Bleeding: As mentioned, the blood vessels of the lipoma are defective and often form aneurysms. Hence, there's a high risk of bleeding into the renal pelvis or the retroperitoneal space, requiring emergency surgery.

Pain: Enlargement of this voluminous formation can lead to compression of the kidney, muscles, and nerves, resulting in pain. Constant, debilitating pain often requires pain relief medication.

Invasion of veins:One of the worst complications: the growth of any tumor, including lipoma, can damage the renal or even the inferior vena cava. This poses the risk of a life-threatening complication: pulmonary artery thromboembolism.

Tuberous sclerosis:Angiomyolipomas can form not only in isolation but also in the context of genetic disorders such as tuberous sclerosis. Therefore, when a lipoma is found, we conduct detailed examinations to exclude this serious condition.

Kidney function: Impairment of kidney function is typical for lipomas and any formations larger than 4 centimeters. These tumors compress renal tissue, depriving the organ of nutrients and causing progressive kidney function impairment.

Oncology: Typically, a kidney lipoma does not transform into a malignant tumor, but sometimes it's very difficult to distinguish kidney cancer from angiomyolipoma. This is why we approach this diagnosis with concern: there's nothing worse than missing kidney cancer.

These issues prompt us to request: upon hearing from a doctor after an ultrasound "a small benign kidney tumor," please undergo further evaluation. Small tumors grow, large ones cause pain, damage blood vessels, and cause dangerous bleeding, and both can mask malignant tumors.

Usually, patients come to us after a kidney lipoma is detected incidentally on ultrasound or computed tomography (CT), and more often in women than in men, especially during menopause.

Methods of Diagnosis:

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Expert Ultrasound (US):
We always repeat kidney US for all patients suspected of kidney tumors, assessing size, blood flow, and compression of neighboring organs, as this is crucial for treatment planning.
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Contrast-Enhanced Kidney CT:
This examination allows distinguishing malignant tumors from lipomas in most cases. It's an essential component of differential diagnosis.
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Kidney MRT:
In rare cases when CT cannot accurately assess the nature of the formation, we prescribe kidney MRI.

How is Angiomyolipoma of the Kidney Treated?

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play icon COMPARISON OF OPEN AND LAPAROSCOPIC KIDNEY RESECTION

In our practice, angiomyolipoma has never been the reason for kidney removal. When the lipoma reaches large sizes, shows dynamic growth, or examination results indicate a risk of rupture, we perform surgical intervention. In such cases, we always offer laparoscopic surgery – a gentle and minimally invasive procedure.

In this video, the advantages of laparoscopic resection are demonstrated:

- No incision

- No pain

- No risk of inflammation

- No unsightly scar.

Advantages of this Approach:

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Guarantee of Removal:
Laparoscopic surgery, although minimally invasive, provides the same guarantee of tumor removal as open surgery.
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Painlessness:
Several punctures in the abdominal wall during laparoscopy do not traumatize the body, significantly reducing the risk of postoperative complications.
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Quick Recovery:
The minimally invasive nature of laparoscopic surgery allows patients to recover much faster than after open surgeries. To put it into perspective, after such an operation, the patient stays in the hospital for 1-2 days.

Our Center has state-of-the-art operating and anesthesia equipment from recognized global leaders in the industry, such as Karl Storz and Olympus. The skill and experience of our specialists, who continuously upgrade their qualifications, enable us to perform kidney resection with consistently successful results and guaranteed avoidance of potential complications.

Our results

Countries
Countries
27
Patients from 27 countries seek surgical treatment from us.
OPERATED PATIENTS
OPERATED PATIENTS
268+
Patients with various kidney tumors have undergone treatment with our doctors.
SERIOUS COMPLICATIONS
SERIOUS COMPLICATIONS
0
No inflammation or suppuration after the procedure.
FAST-TRACK PATIENTS
FAST-TRACK PATIENTS
95%
265 out of 268 patients were discharged on the second day after the operation.
Days
Days
2.2
days on average for hospitalization for laparoscopic surgery.
Tablets
Tablets
1,7
On average, our patients request no more than 1.7 pain relief tablets.

How Surgical Treatment Proceeds in Our Clinic:

1st Day:
Consultation
2nd Day:
CT or MRI
3rd Day:
Laparoscopic Surgery
4th-5th Day:
Discharge

During the initial consultation, we assess the results of previous examinations, perform preliminary analyses, and exclude dangerous conditions such as tuberous sclerosis. A multidisciplinary team discussion is conducted to decide on the need for surgery.

CT or MRI of the kidney is performed at a convenient time for the patient. During this time, we receive the results of preliminary analyses.

The patient is hospitalized, and under general anesthesia, minimally invasive laparoscopic resection or enucleation of the kidney angiomyolipoma is performed.

After the operation, a medical consultation is held to evaluate the surgical outcomes and develop individual recommendations for recovery and further preventive therapy to prevent recurrence.

author
Dr. Oganes E. Dilanyan
Urology-oncology surgeon, Ph.D. of Medical Sciences
Online Consultation
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