Fell due to presyncope, complains of fatigue and left abdominal pain. Large mass palpated in the left abdomen. Blood pressure 90/60 mmHg, regular pulse of 91 BPM. Hemoglobin 8 g/dL.

CT abdomen revealed a previously unknown large left renal angiomyolipoma (AML) with active arterial bleeding. Underwent emergent embolization of all the arteries supplying the AML, including the pseudoaneurysms, with excellent results.

Transferred to the ICU for blood transfusion and surveillance. Recovered promptly.

Angiography courtesy of Dr. Udi Bendet