Presentation
Pregnant female referred for a prenatal ultrasound. Abnormal appearance of both kidneys was observed. CT was requested after delivery.
Patient Data
Bilateral diffuse involvement of the kidneys with multiple differential densities. The right-sided mass measures 125 x 163 mm and the left-sided mass 130 x 145 mm. Both masses have fatty components with CT density -33 HU. Contrast-enhanced scans show patchy and heterogeneous enhancement in the soft tissue and vascular component of the mass lesions. Normal excretion of contrast media was seen on both sides. Multiple areas of blood densities are noted on the right side suggesting hemorrhage. The uterus remains sub-involuted.
Case Discussion
Young female with a long history of chronic anemia, with abnormal appearance of both kidneys discovered incidentally. CT images demonstrate bilateral giant renal angiomyolipomas. Being a common complication with giant angiomyolipomas more than 5 cm, hemorrhage may be the direct cause of the patient's long-lasting anemia. The patient's renal function was within normal limits.
The patient had multiple facial angiofibromas by inspection which raises the odds of tuberous sclerosis.
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