Presentation
Intermittent abdominal pain.
Patient Data
Both kidneys show normal contrast enhancement and contrast excretion. Large well-marginated exophytic heterogeneous predominantly fat attenuating lesion arising from mid-lower portion of right kidney measuring about 24 x 39 x 45 mm. Another small fat attenuating lesion measuring about 8 x 5 mm in lower pole of left kidney. No calcifications are seen in these lesions. Tiny calculus in each kidney.
Liver is enlarged with fatty attenuation. Gallbladder has been removed. Coarse calcifications in right adrenal gland and upper pole of the spleen.
Case Discussion
Angiomyolipoma (AML) is the most common benign solid renal tumor. AML is typically a solid “triphasic” tumor composed of varying amounts of three elements: dysmorphic blood vessels, smooth muscle components, and mature adipose tissue. They are further divided into fat-rich, fat-poor and fat-invisible AML. AML is usually detected incidentally. AML is also seen in patients with tuberous sclerosis complex (TSC) and lymphangioleiomyomatosis (LAM).
In our case, the AMLs show abundant fat, indicating fat-rich AML.
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