Sporadic renal angiomyolipoma with concurrent aneurysm formation

Sporadic renal angiomyolipoma with concurrent aneurysm formation

Roberto Corona-Cedillo, Aime Cedillo-Pozos, Jose Alberto Garcia-de la Fuente, Juan Ignacio Stenner-Perez Gavilan, Ernesto Roldan-Valadez.

Angiomyolipoma is the most common mesenchymal renal neoplasm; it is observed in 0.1 to 0.22% of the general population. The classic form of angiomyolipoma has triphasic histopathologic characteristics, containing variable proportions of dysmorphic blood vessels, smooth muscle, and adipose tissue. Angiomyolipomas that usually are found in patients with tuberous sclerosis tend to bleed because of their hypervascularity and the presence of small aneurysms. CT is the diagnostic tool of choice because of its high sensitivity for detecting fat; thin section non-contrast scans are preferable for measurement of fat density. We present the case of a 35-year-old female patient referred to the emergency room for colicky pain, with occasional irradiation to the right upper quadrant. An abdominal ultrasound was ordered under the suspicion of cholelithiasis; it revealed a mass in the upper lobe of the right kidney. A supplementary abdominal MSCT obtained in both nephrographic (80-120 secs) and excretory (3-5 mins) phase reported a hypodense mass located at the level of the upper pole of the right kidney. A renal angiogram with embolisation of the tumour and aneurysm was performed, and then the patient underwent right open radical nephrectomy. In this report, we discuss the imaging features of the angiomiolipoma as well as the two-step treatment using transarterial embolisation of the tumour and aneurysm followed by radical nephrectomy.

1 - Department of Radiology, Medica Sur Clinic and Foundation.

Mexico City. Mexico.

2 - Directorate of Research, Hospital General de Mexico “Dr Eduardo Liceaga”.

Mexico City, Mexico.

3 - Department of Urology, Medica Sur Clinic and Foundation, Department of Radiology, Hospital General de Mexico “Dr Eduardo Liceaga”,

Mexico City, Mexico.

4 - I.M. Sechenov First Moscow State Medical University (Sechenov

University).

Moscow, Russia.

 

Keywords: angiomyolipoma, aneurysm, embolisation, kidney neoplasm, nephrectomy.

 

Corresponding author: Ernesto Roldan-Valadez, e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Roberto Corona-Cedillo, Aime Cedillo-Pozos, Jose Alberto Garcia-de la Fuente, Juan Ignacio Stenner-Perez Gavilan, Ernesto Roldan-Valadez. Sporadic renal angiomyolipoma with concurrent aneurysm formation. REJR 2020; 10(1):264-270. DOI:10.21569/2222-7415-2020-10-1-264-270.

 

 

Received:       25.12.19                 Accepted:     01.02.20