Liquefaction and Rupture of Angiomyolipoma after Embolization.
Liquefaction and Rupture of Angiomyolipoma after Embolization.
复制标题
栓塞后血管肌瘤的液化和破裂。
DOI：
10.1016/j.jvir.2020.05.021
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Geynisman DM
中科院分区：
文献类型：
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作者：
Uzzo RN;Drevik J;Panaro J;Geynisman DM
一位70岁女性患者出现7.1厘米长的偶发性血管肌脂肪瘤(AML)(图1)。口服依维莫司进行为期6个月的临床试验。患者因再生迅速，一年后需行栓塞术。使用40-300μm颗粒和3 mm可拆卸弹簧圈(Merit Medical，Jordan UT)对优势供血动脉形成的动脉瘤进行了栓塞(图2/补充图1)。4个月后，影像显示完全栓塞并液化。栓塞一年后，患者报告有快速进展的自发性腰部肿块，伴有轻微压痛，无先天创伤。MRI注意到从自发性破裂的完全栓塞型急性髓细胞白血病(图3)开始积液，解剖上追踪并离开下腰椎三角(图4)。需要多次CT引导引流，以清除未感染的液化浆血内容物。随访的MRI显示接近完全消退(补充图2)。在三个月的随访中，患者有轻微的疼痛，并已恢复所有正常活动。
A 70-year-old woman presented with a 7.1-centimeter incidental angiomyolipoma (AML)(Figure 1). Oral everolimus was initiated for six months on clinical trial. The patient required embolization one year later due to rapid regrowth. Embolization was completed using 40–300 μm particles and 3mm detachable coils (Merit Medical, Jordan UT) for an aneurysm arising from the dominant feeding artery (Figure 2/Supplemental Figure 1). Imaging 4 months later revealed complete embolization with liquefaction.One-year post embolization, the patient reported a rapidly progressive spontaneous growing flank mass with mild tenderness without antecedent trauma. MRI noted fluid collections extending from a spontaneously disrupted completely embolized AML (Figure 3) tracking anatomically and exiting the inferior lumbar triangle (Figure 4). Multiple CT guided drains were required to remove uninfected liquefied serosanguinous contents. Follow-up MRI noted near total resolution (Supplemental Figure 2). At three months follow-up the patient had minimal pain and had resumed all normal activities.