Angiomyolipomas associated with TS are more often multiple, are larger, and bleed more often than sporadic AMLs.1 Bleeding can cause pain and weakness and, if severe, may not stop, which may result in anemia and a lifethreatening drop in blood pressure, which warrants urgent medical attention. Of symptomatic cases, 51% present with hemorrhage.2 Symptomatic tumors 4 cm should be considered for treatment by trans - catheter arterial embolization (TAE), enucleation, or partial nephrectomy.2 As the sole therapy, TAE is effective in 90% of tumors and is the first choice of intervention for symptomatic AML.3 Asymptomatic tumors 4 cm should be monitored frequently.1,2 CONCLUSION Angiomyolipomas may arise spontaneously or in the setting of tuberous sclerosis.
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