recent strategies for the management of renal angiomyolipoma: a review of diagnostic and therapeutic approaches

Recent prophylactic treatment options and diagnostic tools show a suboptimal improvement in patients with renal angiomyolipoma (aml). this study was an attempt to review management strategies applied before invasive options. an extensive research on medical databases such as pubmed and scopus was performed from 1999 to 2016 using the following keywords: ‘kidney’, ‘renal’, and ‘angiomyolipoma’. all related studies on patients treating with conservative or minimally-invasive procedures were included. however, reports on surgical treatments were excluded. treatment strategies have been selected based on outcomes resulting from computed tomography (ct) and magnetic resonance (mr) imaging. fat content and tumor size are the most common used indications for amls. unenhanced ct and chemical shift imaging provide good evidence in case of fat-poor amls. chemical analysis and percutaneous biopsy are recommended in case of a diagnostic challenge. a tumor size of 6 cm or larger in diameter might necessitate invasive treatment, while amls patients with tumors around 4cmmay require prophylactic treatment. of all treatment options, embolization indicated a high risk of reintervention. moreover, everolimus and sirolimus as 2 inhibitors of mammalian target of rapamycin (mtor) have been evaluated in clinical trials and demonstrated promising outcomes. in conclusion, advances in imaging techniques along with mtor inhibitors and embolic materials potentiate functional outcomes in amls.