Presentation
Incidental finding on CT abdomen for non-specific abdominal pain.
Patient Data
Fatty mass on the superomedial aspect of the left kidney abutting the left diaphragmatic crus and spleen (arrows). The mass has blood supply from the kidney but is not obviously arising from it. Note a further typical angiomyolipoma in the right kidney (arrow). The left adrenal is clearly seen separate to the mass anteriorly.
Post-operative CT shows surgical clips at the site of excision. Note the adrenal remains in situ and the left kidney is normal apart from minor deformity in the cortex at the site of blood supply to the mass. Surgical specimen was diagnosed pathologically as extra-adrenal angiomyolipoma with no renal parenchymal involvement.
Case Discussion
Extra-renal angiomyolipomas (AML) are rare occurring most frequently in the liver and then retroperitoneum. In the retroperitoneum they are difficult to evaluate as they have similar imaging characteristics to liposarcoma. In this case, the patient fits the demographic of AML (middle-aged female) with another definite AML in her right kidney. At surgery, the mass was completely separate from the kidney and adrenal apart from arterial supply from the ipsilateral kidney.
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