Renal hamartoma

　　Renal hamartoma, also known as renal angiomyolipoma, is a benign tumor. It can be accompanied by tuberous sclerosis, which is an autosomal dominant gene and a hereditary familial disease. 80% of patients have butterfly-shaped sebaceous adenomas on their faces, and other organs such as the brain, eyes, bones, heart, and lungs also have lesions. Delayed brain development, intellectual impairment, and seizures are common, and most cases are multiple foci in both kidneys. The vast majority of renal angiomyolipomas in China do not accompany tuberous sclerosis, 80% are female, and symptoms appear between the ages of 20 to 50, with a majority occurring after the age of 40.

　　The vast majority of hamartoma patients have no obvious symptoms. Only some larger hamartomas may cause gastrointestinal discomfort due to compression of organs such as the duodenum and stomach. Only when a large hamartoma ruptures suddenly, will patients experience lumbar and abdominal pain and hematuria, and severe hemorrhagic patients may feel a mass in the abdomen and even shock symptoms. In this case, emergency actions such as arterial embolization or even kidney surgery may be necessary.

　　⒈ Simple renal hamartomas with small volumes often have no symptoms and are often found during ultrasound or CT examination. Enlarged hamartomas can compress surrounding tissues and abdominal organs, causing corresponding symptoms and discomfort.
　　⒉ If the tumor ruptures, it can cause acute abdominal pain, enlargement of the lumbar mass, and symptoms of internal hemorrhage. Severe cases can lead to hemorrhagic shock.

　　In daily life, it is important to develop good personal hygiene habits, maintain a pleasant mood, avoid great anger, eat more vegetables and fruits, keep the bowels regular, avoid overeating, and eat to about 70-80% of fullness. It is advisable to eat less beef, mutton, pork, and dog meat, and avoid greasy and spicy, strong alcohol, and fried and baked foods. It is recommended to eat light and nutritious foods. However, if you find any symptoms, it is essential to actively go to the hospital for a medical consultation and cooperate with the doctor for proper treatment.

　　Laboratory examination: Due to the tumor being close to the collecting system, it can cause hematuria after rupture. Urinalysis may show occult blood. Double renal hamartomas may show hypertension and renal insufficiency, with abnormal blood creatinine and urea nitrogen levels.
　　Imaging examination
　　1. Ultrasound is quite characteristic, with the fat and vascular parts of the tumor showing uniformly distributed dense hyperechoic areas, while the muscle and hemorrhagic parts show hypoechoic areas.
　　2. X-ray abdominal flat film shows unclear renal contour, disappearance of the lumbar muscle shadow, and calcification in the renal area. Urinary road造影 shows that the mass compresses the renal pelvis and calyces, causing deformation, elongation, and shortening, but without侵蚀 phenomena.
　　3. CT is the main method for diagnosing renal hamartoma. It presents as a mass with uneven density, containing a high fat content, with a CT value of -90 to -40Hu.

　　1. What foods should be eaten for renal hamartoma to be beneficial to the body:

　　(1) It is recommended to eat light and nutritious foods, with an emphasis on fresh vegetables and fruits. It is beneficial to consume foods that can resist renal tumors, such as turtles, soft-shelled turtles, sea horses, sandworms, king cobras, ambergris oil, jellyfish, sea cucumbers, pork and beef bone marrow, water chestnuts, figs, bitter herbs, cucumbers, papayas, Job's tears, silkworms, pommelos, and mulberry seeds.

　　(2) It is advisable to eat more foods that enhance physical fitness and boost the immune system, such as sardines, shrimps, crucian carp, eels, oysters, scallops, pork liver, pork kidneys, Job's tears, lotus seeds, walnuts, apples, kiwi fruit, broad beans, adzuki beans, placenta, bee milk, and sesame seeds.

　　(3) It is recommended to consume foods such as toads, baobab fruits, Job's tears, coriander, pork and beef bone marrow, broad beans, walnuts, pork kidneys, abalone, horseshoe crab, sea snake, oysters, and sea cucumber for lumbar pain.

　　(4) Hematuria: Eat turtle, tortoise, pangolin meat, fig, black plum, persimmon, lotus seed, lotus root, chrysanthemum, celery, winter melon, reed root, sugarcane, mustard green, mulberry.

　　(5) Edema: Eat sheep lung, jellyfish,螺, 文蛤, seaweed, laver, crucian carp, cuttlefish, bluefish, clam, crucian carp, celery, mung bean, chrysanthemum, mushroom.

　　2. Foods that renal hamartoma patients should not eat:

　　Eat less beef, mutton, pork, and dog meat. Avoid greasy, rich, strong alcohol, and spicy fried foods.

　　No matter which treatment method is adopted, the preservation of renal function should be given top priority.

　　1. Interventional embolization therapy:Generally speaking, interventional embolization therapy is simple and safe, but some scholars believe that this treatment method is not thorough and cannot guarantee the complete blockage of blood supply to the hamartoma, so there is a possibility of secondary embolization or conversion to surgical treatment. However, it is a good emergency method for bleeding due to rupture.

　　2. Surgical treatment:The surgical method of preserving renal tissue, which we call partial nephrectomy, not only allows for the complete removal of the tumor but also retains renal tissue to the maximum extent and protects renal function, resulting in a good long-term effect. It is of great significance for the treatment of renal hamartoma (including cases with partial rupture and bleeding).

　　Partial nephrectomy for renal hamartoma is divided into open surgery and laparoscopic surgery. According to the current level of medical technology, it is recommended to choose laparoscopic surgery first, which not only has less trauma, completely removes the tumor, but also retains pathological samples to confirm the nature of the tumor. In recent years, laparoscopic surgery has gradually become the preferred method for treating renal hamartoma due to its unique advantages such as less trauma, fast wound healing, short hospital stay, less bleeding, and aesthetic incisions.

　　The treatment of renal hamartoma mainly depends on symptoms, tumor size, and other factors.

　　For asymptomatic tumors with a diameter less than 4 centimeters, due to the low risk of spontaneous rupture, they can be closely observed and actively monitored for the progression of tumor size;

　　If the diameter of the hamartoma exceeds 4 centimeters and the tumor is progressively increasing or there is a suspicion of malignant tendency, it is recommended to surgically remove it;

　　If the tumor volume is large and it breaks and bleeds, consider performing interventional embolization therapy first, and then re-evaluate the condition after the disease stabilizes to decide whether to perform surgical treatment according to the situation.