Tommy Kjærgaard Nielsen

Laparoscopic cryoablation of angiomyolipomas in adolescents and young adults: a report of 4 cases associated with tuberous sclerosis and 1 case of sporadic origin

Publikation: KonferencebidragKonferenceabstrakt til konferenceFormidling

The present study reports the first series of laparoscopic cryoablation of renal angiomyolipomas (AML) in adolescents and young adults.

From October 2009 to September 2013 five patients at our institution were diagnosed with AML requiring treatment. Four patients had tuberous sclerosis (TS) and one had AML of sporadic origin, all five patients underwent laparoscopic cryoablation. Perioperative data was prospectively registered in a nation-wide laparoscopy database with follow-up data collected from the patients’ chart. Independent radiologists reassessed all imaging.

Median age was 16 (13–27) years. Eight AMLs in five patients, with a median size of 3.9 (2.1-7.7) cm were treated. Indication for intervention within the TS group was prophylactic due to tumor size and rapid growth. The patient with sporadic AML was treated due to tumor size and a former bleeding episode. From time of diagnosis until intervention the patients with TS were followed with renal imaging for a median time of 117 (1–140) months. After cryoablation AML-status was followed by CT and MRI for a median follow up time of 37 (6–59) months. On follow-up imaging, all lesions showed a reduction in tumor size, and no regrowth was recognized.
The procedure was well tolerated, with few minor intraoperative complications and all patients scored zero in the Clavien-Dindo classification as no postoperative complications occurred.

Treating AMLs with laparoscopic cryoablation appears to be a safe and feasible nephron-sparing approach in adolescents and young adults, thus supporting the future use of cryoablation in this patient group. For inferior, lateral and peripherally located lesions, percutaneous cryoablation is a less invasive option, but none of our patients had lesions appropriate for this approach. Treatment with mTOR inhibitors is an alternative and promising non-invasive treatment for TS-patients with AMLs not requiring immediate surgery.
StatusUdgivet - 2015
BegivenhedNUF Congress 2015 - Malmö, Sverige
Varighed: 3 jun. 20155 jun. 2015


KonferenceNUF Congress 2015

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