| Objective:To investigate the etiology, clinical characteristics, diagnosis and treatment, prognostic factors of invasive angiomyolipoma with tumor thrombus in the vein, try to improve the diagnosis and treatment of invasive angiomyolipoma with tumor thrombus in the vein.Methods:Retrospective analyses of 7 cases with invasive angiomyolipoma with tumor thrombus in the vein in our hospital from 2008 to 2016, and 5 of the cases were followed up. Statistical anslysis of the clinical characteristics were made, and compare the treatments, prognosis and the surgical methods.Results:In the 7 cases, the maximum age is 77 years old, and the minimum age is 21 years old. 3 patients were invasive angiomyolipoma with thrombus in the renal vein,3 patients had invaded the IVC,1 patient had invaded the right atrium.2 patients were asymptomatic,1 had gross hematuria, and 3 had flank pain. All cases were examined by ultrasound and CT. CT reported that 4 patient may be angiomyolipoma, while 3 may had renal cell carcinoma, and 4 of 7 were revealed a thrombus in the vein,1 had a possibility of a thrombus. All the 7 patients underwent operation, and the postoperative pathology showed that 1 was angiomyolipoma conbined with renal cell carcinoma, the other 6 were angiomyolipoma. And 2 of 7 were epithelioid angiomyolipoma. Patients were followed up for 6 months to 7 years,1 patient died 10 months later for brain metastasis,1 died 11 months later with metastasis to the lung,5 cases were survived, the followed up patients were all without distant metastasis.Conclusion:Invasive angiomyolipoma with tumor thrombus in the vein are rare in clinical. For invasive AML with tumor thrombus extending to the renal vein or the IVC, radiological staging is necessary in selecting patients for surgical treatment. Surgical treatment is the first choice for these patients. Early diagnosis and timely treatment for invasive AML with tumor thrombus can prolong the survival and the living quality significantly. |
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