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

• Published in: Surgical practice 2018-11, Vol.22 (4), p.185-191
• Main Authors: Ng, Tsz‐Leung, Chu, Ringo Wing‐Hong, Leung, Clarence Lok‐Hei, Chan, Wayne Kwun‐Wai, Cho, Chak‐Lam, Law, In‐Chak, Kan, Chi‐Fai, Ho, Lap‐Yip, Au, Wing‐Hang
• Format: Article
• Language: English
• Subjects: Health risk assessment; Literature reviews; Pregnancy; Pregnancy complications
• ISSN: 1744-1625; 1744-1633
• DOI: 10.1111/1744-1633.12314

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.