Recurrent Symptomatic Renal Angiomyolipoma After Selective Arterial Embolization: A Case Report

A middle-aged woman with a history of a large right renal angiomyolipoma (AML), previously treated with selective arterial embolization, presented to our facility with a sudden onset of recurrent right-sided abdominal pain. Despite a prolonged asymptomatic period following her initial procedure, clinical evaluation and laboratory testing were initiated to investigate the recurrence. Cross-sectional imaging revealed an increase in the size of the residual mass and areas of hyperdensity, suggesting minor recurrent hemorrhage. Subsequent digital subtraction angiography was performed, which provided a definitive characterization of the vascular supply, demonstrating partial recanalization of previously embolized vessels and a prominent residual tumor blush. Following a multidisciplinary review, the patient underwent a repeat selective arterial embolization. The procedure was successful, achieving total devascularization of the target area. Post procedure, the patient experienced complete symptom resolution. Long-term follow-up confirmed sustained clinical stability and radiological improvement, demonstrating that repeat embolization is an effective nephron-sparing strategy for managing late-stage recanalization in renal AML.