OBJECTIVE: To explore the diagnosis and treatment of tuberous sclerosis complex 
complicated with renal angiomyolipoma.
METHODS: The clinical data of 22 patients with tuberous sclerosis complex 
complicated with renal angiomyolipoma were analyzed retrospectively.
RESULTS: There were 12 males and 10 females with a mean age of 23 (1-46) years. 
All of them had bilateral multiple renal angiomyolipomas. The mean tumor size 
was 8.5 (0.7-18.0) cm in diameter. The presence or absence of clinical symptoms 
showed a significant correlation with tumor size.Eight patients with 
angiomyolipoma under 4 cm in diameter were continuously monitored at an 
outpatient clinic. There were 8 patients with lesions of 4-10 cm.Five of them 
underwent nephron-sparing surgeries and another 3 monitored at an outpatient 
clinic. There were 6 patients with tumor over 10 cm. Three of them underwent 
transcatheter arterial embolization and one case took rapamycin after 
embolization.One patient with concurrent renal cell carcinoma underwent partial 
nephrectomy. Chronic renal failure occurred in one case dying of pulmonary 
lymphangiomyomatosis with serious hemoptysis. During a mean follow-up of 25 
months, neither severe renal hemorrhage nor symptomatic aggravation was found.In 
the case of rapamycin, there was 10% reduction in the size of angiomyolipoma.
CONCLUSIONS: Most cases of tuberous sclerosis complex are complicated with 
bilateral multiple renal angiomyolipoma. The small lesions under 4 cm in 
diameter may be monitored at an outpatient clinic.For those larger (>4 cm) or 
symptomatic ones, medication, embolization or surgery is necessary.