Selective embolization of a renal angiomyolipoma using n-butyl-2-cyanoacrylate‒lipiodol‒iopamidol mixture under microballoon occlusion resulting in tumor reduction and preservation of normal renal blood flow: A case report

A renal angiomyolipoma associated with sporadic lymphangioleiomyomatosis was found in the left kidney of a 30-year-old woman. The tumor had a maximum diameter of 56 mm, and there was a 5 mm diameter aneurysm within the tumor. Embolization using <i>n</i>-butyl-2-cyanoacrylate (NBCA)‒Lipiodol‒iopamidol mixtures was planned to prevent the tumor from rupturing. Under microballoon occlusion, NBCA:Lipiodol:iopamidol (1:4:1) mixture was injected into the peripheral part of the tumor and NBCA:Lipiodol:iopamidol (2:3:1) mixture was injected into the proximal part. Embolization completely occluded the feeding arteries of the tumor, and normal renal blood flow was preserved. Computed tomography performed 15 weeks after embolization showed that the embolized branches were completely occluded and normal renal blood flow was maintained. The maximum diameter of the tumor had decreased to 39 mm.