Extracortical renal angiomyolipoma
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A circumscribed, largely extracortical, markedly echogenic mass is visible in the lower pole of the left kidney.
The lesion was known from prior imaging, and its distinct, homogeneously echogenic appearance and lack of change over more than a decade is virtually pathognomonic for renal angiomyolipoma. While even tiny angiomyolipomas within the cortex are diagnosed with ease, lesions that are predominantly extracortical can be overlooked due to the lack of contrast between the tumor and the perirenal fat.