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Pediatric Reports
Volume 12
Issue 2
10.4081/pr.2020.8352
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Case Report

Renal Angiomyolipomatosis and Bleeding Aneurysms in a Tuberous Sclerosis Context: Selective Artery Embolization in a Girl with End-Stage Renal Failure

by
Gloria Pelizzo
1,*,
Mario Giuseppe Vallone
2,
Mario Milazzo
3,
Gregorio Rosone
3,
Salvatore Amoroso
3,
Giovanni Pavone
4,
Maria Michela D'Alessandro
4,
Elettra Unti
5 and
Valeria Calcaterra
6
1
Department of Biomedical and Clinical Science ”L Sacco”, University of Milan, Department of Pediatric Surgery, Children's Hospital V. Buzzi", Milan
2
Operative Unit of Vascular Radiology and Endovascular Therapy, ARNAS Civico-Di Cristina-Benfratelli, Palermo
3
Pediatric Unit, ARNAS Civico-Di Cristina-Benfratelli, Palermo
4
Pediatric Nephrology Unit, ARNAS Civico-Di Cristina-Benfratelli, Palermo
5
Pathology Unit, ARNAS Civico-Di Cristina-Benfratelli, Palermo
6
Pediatrics and Adolescents Unit, Department of Internal Medicine University of Pavia; Children’s Hospital “Vittore Buzzi”, Milano, Italy
*
Author to whom correspondence should be addressed.
Pediatr. Rep. 2020, 12(2), 8352; https://doi.org/10.4081/pr.2020.8352
Submission received: 29 October 2019 / Revised: 29 October 2019 / Accepted: 25 February 2020 / Published: 6 August 2020

Abstract

Recent developments in endovascular radiological techniques and devices have rendered embolization a major therapeutic option prior to surgery in many renal vascular or neoplastic diseases. A 19-yearold female patient, with a diagnosis of tuberous sclerosis complex (TSC) in childhood, was admitted with severe anemia. Polycystic kidney disease in end-stage renal failure appeared four years before and the patient has been undergoing peritoneal dialysis. The patient’s medical history also included bilateral renal angiomyolipomas (AMLs). One year earlier, a unilateral endovascular embolization was performed to repair a bleeding aneurysm at the right renal upper pole. A second bilateral ruptured renal aneurysm was diagnosed at admission. To continue with peritoneal dialysis and prevent intrarenal hemorrhage and intraperitonal bleeding, an urgent bilateral renal AE was performed. Two months later she underwent a bilateral retroperitoneal nephrectomy. The posterior surgical approach, preserved the peritoneal surface area and adequate conditions to continue dialysis. At histology, bilateral AMLs were confirmed and a renal cell carcinoma of the right kidney was concurrently discovered. She undergoes continuous peritoneal dialysis. Urgent selective renal AE represents a feasible treatment for bilateral AML bleeding. It is safe and feasible before performing nephrectomy in patients with end-stage renal failure.
Keywords: renal artery embolization; angiomyolipoma; bleeding aneurysms; tuberous sclerosis context; end-stage renal failure renal artery embolization; angiomyolipoma; bleeding aneurysms; tuberous sclerosis context; end-stage renal failure

Share and Cite

MDPI and ACS Style

Pelizzo, G.; Vallone, M.G.; Milazzo, M.; Rosone, G.; Amoroso, S.; Pavone, G.; D'Alessandro, M.M.; Unti, E.; Calcaterra, V. Renal Angiomyolipomatosis and Bleeding Aneurysms in a Tuberous Sclerosis Context: Selective Artery Embolization in a Girl with End-Stage Renal Failure. Pediatr. Rep. 2020, 12, 8352. https://doi.org/10.4081/pr.2020.8352

AMA Style

Pelizzo G, Vallone MG, Milazzo M, Rosone G, Amoroso S, Pavone G, D'Alessandro MM, Unti E, Calcaterra V. Renal Angiomyolipomatosis and Bleeding Aneurysms in a Tuberous Sclerosis Context: Selective Artery Embolization in a Girl with End-Stage Renal Failure. Pediatric Reports. 2020; 12(2):8352. https://doi.org/10.4081/pr.2020.8352

Chicago/Turabian Style

Pelizzo, Gloria, Mario Giuseppe Vallone, Mario Milazzo, Gregorio Rosone, Salvatore Amoroso, Giovanni Pavone, Maria Michela D'Alessandro, Elettra Unti, and Valeria Calcaterra. 2020. "Renal Angiomyolipomatosis and Bleeding Aneurysms in a Tuberous Sclerosis Context: Selective Artery Embolization in a Girl with End-Stage Renal Failure" Pediatric Reports 12, no. 2: 8352. https://doi.org/10.4081/pr.2020.8352

APA Style

Pelizzo, G., Vallone, M. G., Milazzo, M., Rosone, G., Amoroso, S., Pavone, G., D'Alessandro, M. M., Unti, E., & Calcaterra, V. (2020). Renal Angiomyolipomatosis and Bleeding Aneurysms in a Tuberous Sclerosis Context: Selective Artery Embolization in a Girl with End-Stage Renal Failure. Pediatric Reports, 12(2), 8352. https://doi.org/10.4081/pr.2020.8352

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