Presentation
Patient with dilated cardiomyopathy, CT scan performed as a part of work-up for heart transplantation.
Patient Data
In the upper to the mid-third of the left kidney, a sharply defined oval mass is shown, containing fat tissue. A hyperdense content is found anteriorly in the mass which is not showing postcontrast opacification. The findings indicate hemorrhage in angiomyolipoma of the left kidney.
This is a CT scan 4 years prior to the above mentioned CT scan. The angiomyolipoma of the left kidney is seen, somewhat smaller in size and without any signs of hemorrhage.
Case Discussion
Angiomyolipoma is the most frequent mesenchymal tumor of the kidney. It is composed of vascular, smooth muscle and fat tissue. The hemorrhagic tendency is related to the vascular component, most likely due to the presence of aneurysmatic, irregular vessels. The tumor size and the association with tuberous sclerosis complex also contribute to the risk of hemorrhage. Retroperitoneal hemorrhage and/or bleeding into the renal collecting system both may put the patient’s life at risk.