Successful treatment with sirolimus for an angiomyolipoma mimicking renal cell carcinoma in a transplanted kidney

Transpl Int. 2015 Sep;28(9):1116-20. doi: 10.1111/tri.12567. Epub 2015 Apr 6.

Abstract

Angiomyolipoma (AML) is a benign mesenchymal tumor composed of blood vessels, smooth muscle, and mature adipose tissue. AMLs in the kidney allografts are rare. We report a case of AML that was incidentally found 1 year after transplantation. Abdominal computed tomography showed a 4-cm renal tumor with contrast enhancement and an early washout pattern, resembling a renal cell carcinoma. Tumor biopsy proved a lipid-poor AML. Tumor diameter decreased to 2.4 cm after 6 months of treatment with sirolimus. Sirolimus not only reduces tumor size, but also benefits a transplant patient who needs immunosuppression.

Keywords: angiomyolipoma; mammalian target of rapamycin inhibitor; renal cell carcinoma; renal transplantation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angiomyolipoma / complications
  • Angiomyolipoma / drug therapy*
  • Biopsy
  • Carcinoma, Renal Cell / diagnosis*
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunosuppression Therapy
  • Immunosuppressive Agents / therapeutic use
  • Kidney / pathology
  • Kidney Neoplasms / complications
  • Kidney Neoplasms / drug therapy*
  • Kidney Transplantation / adverse effects*
  • Nephrectomy
  • Renal Insufficiency / complications
  • Renal Insufficiency / surgery*
  • Sirolimus / therapeutic use*
  • TOR Serine-Threonine Kinases / metabolism
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • MTOR protein, human
  • TOR Serine-Threonine Kinases
  • Sirolimus