Volume 22, Issue 4 pp. 185-191
CASE REPORT

Spontaneous rupture of renal angiomyolipoma during pregnancy: A report of two cases and literature review

Tsz-Leung Ng

Tsz-Leung Ng

Department of Surgery, Queen Elizabeth Hospital, Hong Kong

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Ringo Wing-Hong Chu

Corresponding Author

Ringo Wing-Hong Chu

Department of Surgery, Kwong Wah Hospital, Hong Kong

Author to whom all correspondence should be addressed.

Email:[email protected]

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Clarence Lok-Hei Leung

Clarence Lok-Hei Leung

Department of Surgery, Kwong Wah Hospital, Hong Kong

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Wayne Kwun-Wai Chan

Wayne Kwun-Wai Chan

Department of Surgery, Kwong Wah Hospital, Hong Kong

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Chak-Lam Cho

Chak-Lam Cho

Department of Surgery, Kwong Wah Hospital, Hong Kong

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In-Chak Law

In-Chak Law

Department of Surgery, Kwong Wah Hospital, Hong Kong

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Chi-Fai Kan

Chi-Fai Kan

Department of Surgery, Queen Elizabeth Hospital, Hong Kong

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Lap-Yip Ho

Lap-Yip Ho

Department of Surgery, Queen Elizabeth Hospital, Hong Kong

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Wing-Hang Au

Wing-Hang Au

Department of Surgery, Queen Elizabeth Hospital, Hong Kong

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First published: 23 April 2018

Abstract

Spontaneous rupture of renal angiomyolipoma (AML) during pregnancy is a rare but life-threatening condition. In the present study, we report two of our cases and provide a literature review of 23 case reports. We retrospectively reviewed two pregnant women who presented with spontaneous ruptured AML; both failed conservative management. In our first case, a 36-year-old woman at 9 weeks’ gestation had selective renal arterial embolization with pelvic shield performed successfully. The pregnancy was continued to term, and the baby was delivered by elective Caesarean section. In our second case, a 33-year-old woman, pregnant with twins, at 32 weeks’ gestation had emergency Caesarean section performed uneventfully. On-table selective renal arterial embolization was performed immediately afterwards, and the patient stabilized afterwards. Taken together with the 23 case reports in the literature, we conclude that embolization is a safe option of active intervention for ruptured AML in pregnancy when conservative management fails. It has the advantages of being minimally invasive and nephron-sparing. The risk of radiation to the foetus is acceptable if proper measures are taken to minimize foetal radiation exposure.

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