Abstract
Objectives
To describe the natural history of AML, the clinical results and the need for treatment during long-term follow-up of renal AML.
Methods
Retrospective study of patients diagnosed with AML by computed tomography or nuclear magnetic resonance between 2001 and 2019, with at least two follow-up images. Clinical and imaging variables, need for intervention, complications and follow-up time were recorded. Statistical analysis was performed using SPSS 22.0.
Results
111 patients and 145 AML were included. The median follow-up was 6.17 years (range 0.7–18.1, IQR 11.8–12.2). The median tumor size at diagnosis was 13 mm (IQR 7.5–30), with 24 (16.4%) being ≥ 4 cm. Most presented as an incidental finding (85.5%); in 3 (2.1%) cases, the presentation was as a spontaneous retroperitoneal hematoma. The main indication for intervention was size ≥ 4 cm in 50%. Eighteen (12%) patients received a first intervention, being urgent in 3. Embolization was performed in 15 cases and partial nephrectomy in 3. The need for reintervention was recorded in five: two underwent partial nephrectomy and two total nephrectomy; one patient required a new urgent embolization. Of the non-operated patients, 43% decreased in size or did not change, while 57% increased, with the median annual growth being 0.13 mm (IQR − 0.11 to 0.73). There were no differences in the median growth in tumors measuring ≥ 4 cm (0.16 mm) at diagnosis vs. < 4 cm (0.13 mm) (p = 0.9).
Conclusions
The findings of this study suggest that AML typically demonstrate a slow-progressing clinical course during long-term follow-up. Moreover, our observations, which cast doubt on tumor size as a reliable predictor of adverse clinical outcomes, advocate for a less intensive monitoring strategy in both monitoring frequency and choice of imaging modality.
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The data underlying this article will be shared on reasonable request to the corresponding author.
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Aumatell, J., Schwartzmann, I., Bravo-Balado, A. et al. Natural history of renal angiomyolipoma in a high-volume center: our experience during more than 15 years of follow up. Int Urol Nephrol 56, 1551–1557 (2024). https://doi.org/10.1007/s11255-023-03839-z
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DOI: https://doi.org/10.1007/s11255-023-03839-z