Urgent angioembolization with early elective nephron-sparing surgery for spontaneously ruptured renal angiomyolipoma

Tumor rupture with hemorrhage is a severe complication of renal angiomyolipoma. Urgent transcatheter arterial embolization is an effective method for the patient suffering from life-threatening hemorrhage due to ruptured angiomyolipoma. Elective surgery has been suggested because of the possibility of rebleeding or abscess formation after embolization. However, it is not easy to perform a nephron-sparing procedure by delayed elective surgery due to severe tissue adhesion after bleeding. Herein, we report 2 cases of ruptured renal angiomyolipoma initially managed with transcatheter arterial embolization. Nephron-sparing surgery was performed a few days after embolization, before tissue adhesion occurred. Both kidneys were preserved, and the postoperative course was uneventful.