A Review of the Literature on Extrarenal Retroperitoneal Angiomyolipoma

Table 1

A table of reported cases of extrarenal retroperitoneal angiomyolipoma.

Case	Reference	Presentation	Age (years)/; sex	Size	Imaging	Location	Treatment	Outcome/follow-up
1	Friis and Hjortrup 1982 [5]	Pain and weight gain	22/; female	11 kilograms	Intravenous urography	Peripancreatic space	Radical nephrectomy	Asymptomatic/36 months
2	Randazzo et al. 1987 [6]	Pain and bleeding	64/; female	6 cubic cms	IVU and CT scan	Right perinephric space	Renal sparing surgery	Asymptomatic/2 months
3	Ditonno et al. 1992 [7]	Pain and bleeding	37/; male	5 cm	IVU and CT scan and angiography	Right perinephric space	Radical nephrectomy	Details not available
4	Peh et al. 1994 [8]	Abdominal mass and weight loss	32/; female	3.7 kilograms (7980 cubic cms)	Ultrasound scan and CT scan	Left perinephric space	Radical nephrectomy	Asymptomatic/8 months
5	Angulo et al. 1994 [9]	Abdominal pain and flank pain	53/; female	336 cubic cms	Ultrasound scan, CT scan, and angiography	Left perinephric space	Radical nephrectomy	Details not available
6	Gupta and Guleria 2011 [10]	Abdominal pain	42/; Male	220 cubic cms.	Ultrasound scan and CT scan	Right adrenal space	Renal sparing resection	Details not available
7	Liwnicz et al. 1994 [11]	Abdominal pain	39/; female	1.1 kilograms (216 cubic cm)	CT scan	Right perinephric space	Radical nephrectomy	Asymptomatic/18 months
8	Law et al. 1994 [12]	Incidental finding	59/; female	22.5 cubic cm	CT scan and MRI scan	Left perinephric space	Radical nephrectomy	Details not available
9	Law et al. 1994 [12]	Pain	56/; female	11 cm	IVU, CT Scan, ultrasound and fine needle aspiration	Left perinephric space	Radical nephrectomy	Asymptomatic/8 months
10	Mogi et al. 1998 [13]	Abdominal fullness and pain	41/; female	648 cubic cm	CT scan and MRI scan	Right perinephric space and perihepatic space	Renal sparing resection of mass	Details not available
11	Murphy et al. 2000 [14]	Abdominal pain and bleeding	51/; female	Details not described	CT scan and angiography	Left perinephric space	Selective angiography embolization	Asymptomatic/12 months
12	Tsutsumi et al. 2001 [15]	Abdominal pain and fatigue (lethargy)	60/; female	3.5 kilograms (4840 cubic cm)	CT scan and angiography	Right perinephric space	Radical nephrectomy	Asymptomatic/60 months
13	Tseng et al. 2004 [16]	Fullness of abdomen	35/; female	2.8 kilograms (3726 cubic cm)	Ultrasound scan, CT scan and angiography	Right perinephric space	Renal sparing resection	Details not available
14	Obara et al. 2005 [17]	Visible haematuria	31/; male	Details not documented	CT scan and angiography	Right perinephric space	Radical nephrectomy	Details not available
15	Gupta et al. 2007 [4]	Abdominal pain	80/; female	16 cm	CT scan and MRI scan	Left perinephric space	Radical nephrectomy	Distant metastases in bone and liver/12 months
16	Minja et al. 2012 [18]	Asymptomatic	39/; female	1.7 kilograms (2898 cubic cm)	Ultrasound scan/CT scan	Left perinephric space	Radical nephrectomy	Asymptomatic/16 months
17	Lee et al. 2003 [19]	Increasing abdominal circumference and urinary frequency	35/; female	24 cm × 21 cm × 16 cm	CT scan	Right retroperitoneal region displacing right kidney to left	Wide excision with preservation of kidney (kidney sparing resection of mass)	Asymptomatic/4 months
18	Soni et al. 2013 [20]	Left sided abdominal pain	33/; female	9.3 cm × 6.1 cm × 7.7 cm	CT scan	Left pararenal retroperitoneal space	Kidney preservation excision of mass	Follow-up information was not available
19	Ivanova et al. 2014 [21]	Right sided lumbar ache	33/; female	10 cm × 6 cm	Radiological imaging type not available	Right retroperitoneal space	Kidney preserving resection	Follow-up information was not available
20	Welling et al. 2012 [22]	Incidental finding of staging FDG PET/CT scan for melanoma of right flank	38/; male	Hypermetabolic extrarenal mass size not available	FDG PET/CT scan done as staging CT for melanoma	Left retroperitoneal space	Details of surgery not available	Follow-up information not available
21	Fegan et al. 1997 [23]	Details not available	Details not available	Details not available	Details not available	Extrarenal retroperitoneal details not available	Details not available	Details not available
22	Lau et al. 2003 [24]	Details not available	Details not available	Details not available	Details not available	Extrarenal retroperitoneal details not available	Details not available	Metastases reported in the abstract to the liver and mediastinum (the questions needed to be asked: are the lesions true metastases? Or are they de novo primaries in the liver and mediastinum? If they are metastases then should angiomyolipoma not be classified as malignant tumours?)
23	Wen et al. 2014 [25]	History of tuberous sclerosis and left renal AML had preoperative embolization plus left nephrectomy 15 years earlier. Presented with loss of appetite, vomiting, abdominal pain, constipation, and palpable mass in abdomen	45/; female	Large right extrarenal retroperitoneal mass and lesions in other sites	CT scan	Right retroperitoneal AML and lesions elsewhere	Radical excision of mass sparing the kidney	Asymptomatic at 1-year follow-up (in view of the fact that patients with tuberous sclerosis have a tendency to develop lesions in multiple sites, it would be argued that the ERAML that developed 15 years later was a de novo lesion rather than metastatic lesion. On the contrary other people could argue that perhaps the lesion was a late metastatic lesion).
24	Wang et al. 1997 [26]	Abdominal pain and weight loss plus spontaneous bleeding in the tumour	48/; female	Size not available	CT scan	Left retroperitoneal space	Left nephrectomy together with excision of the mass	Follow-up information not available
25	Daniel et al. 2010 [27]	Details not available	34/; female	Large	No available information on imaging	Left retroperitoneal space		Follow-up details not available
26	Vîlcea et al. 2015 [28]	Irreducible right inguinofemoral mass considered to be irreducible hernia	65/; male	Large; 15 cm × 25 cm	CT scan and intravenous urography	Large right retroperitoneal mass down to inguinal femoral canal and pushing away nearby organs	Wide excision	Asymptomatic/7 years
27	Mansi et al. 2002 [29]	Details not available	Details not available	Details not available but large	Details not available	Retroperitoneal but details not available		Details not available
28	Ahmad et al. 2006 [30]	Right back pain	44/; female	14 cm × 10 cm × 6 cm	MRI scan; CT guided biopsy of mass	Right retroperitoneal	Excision of the mass	Follow-up details not available
29	Molina et al. 2001 [31]	Spontaneous abortion in first pregnancy associated with complications; diagnosis was incidentally made during imaging investigations	28/; female	Size not available	Ultrasound scan and CT scan	Left retroperitoneum	Excision of mass	Follow-up information not available
30	Medina et al. 2002 [32]	Abdominal distension	25/; sex of patient not available	Large extending from pelvis to umbilical region	Ultrasound scan and CT scan and radiological imaging biopsy	Retroperitoneal space extending from pelvis to umbilical region	Details of treatment not available	Follow-up details not available