Angiomyolipoma of colon: unusual presentation

Angiomyolipomas are benign mesenchymal tumors mostly arising from the kidney. Angiomyolipoma of the colon is extremely rare. Here we report the findings of a 72 years gentleman who presented with recurrent episodes of abdominal pain and fullness of one year duration. Colonoscopy was suggestive of polypoidal lesion in the descending colon. CECT abdomen revealed a colocolic intussusception in the descending colon with lipoma as a leading point. He underwent a standard left hemicolectomy. Histopathological examination showed that the tumor of 5.7 cm in diameter included smooth muscle (spindle cell type), mature adipose tissue, and vessels, and therefore a diagnosis of angiomyolipoma was made. We believe this is the second report of colonic angiomyolipoma presenting with colocolic intussusception.

Thermoablatiós lehetőségek a benignus térfoglaló képletek gyógyításában

Introduction: Depending on their size and location, some benign tumors can cause prolonged discomfort and even rupture and fatal bleeding in severe cases. Hitherto the therapeutic strategies for such lesions were observation, surgery and in selected cases transarterial embolization. Aim: Our aim was to present the possibilities of thermoablation for treating lesions. Method: Here we present interventions of four patients in Semmelweis University Department of Transplantation and Surgery. A thyroid adenoma and a kidney angiomyolipoma were treated with radiofrequency ablation. Two patients with a liver haemangioma were treated with microwave thermoablation technique. Results: Complications were not observed in any of the cases. In most cases, the size of the treated lesions decreased. The mean decrease in volume was 32.7%. The contrast enhancement of the lesions also decreased, the mean reduction in contrast enhancing volume was 75.3%. Conclusions: Thermoablational procedures for the benign tumors presented above are safe. The therapy shows excellent cosmetic results, a shorter hospital stay and quicker recovery. Orv. Hetil., 2016, 157(51), 2040–2047.

Bilateral diaphragmatic paralysis after kidney surgery

A 57-year-old woman underwent an enucleoresection of her right kidney angiomyolipoma. Two weeks later she was admitted to our hospital because of dyspnea at rest with orthopnea. The chest x-ray showed the elevation of both hemidiaphragms and the measurement of the sniff transdiaphragmatic pressure confirmed the diagnosis of bilateral diaphragmatic paralysis. A diaphragm paralysis can be ascribed to several causes, i.e. trauma, compressive events, inflammations, neuropathies, or it can be idiopathic. In this case, it was very likely that the patient suffered from post-surgery neuralgic amyotrophy. To our knowledge, there are only a few reported cases of neuralgic amyotrophy, also known as Parsonage- Turner Syndrome, which affects only the phrenic nerve as a consequence of a surgery in an anatomically distant site.