Haemorrhagic angiomyolipoma with subsequent embolisation

Case contributed by Dr Morlie L Wang

Presentation

Acute left flank pain.

Patient Data

Age: 50 years
Gender: Female
CT

CT abdomen and pelvis

CT of the abdomen demonstrates a large fat density mass arising from the lower pole of the left kidney. It is associated with significant surrounding fluid which extends down towards the pelvis, and up behind the kidney. 

DSA (angiography)

Embolisation

Initial injection into the renal artery demonstrates brisk extravasation of contrast inferiorly, consistent with rapid ongoing bleeding. A microcatheter was navigated into bleeding vessel and glue was used to occlude it (not shown).

CT

CT abdomen and pelvis

At the inferior pole of the left kidney the a fat-containing soft tissue mass measuring 8.7 x 11.2 x 11.9 is again demonstrated. There is a new curvilinear hyperdense focus within the fat-containing lesion representing sequelae of interval vascular glue embolization. The HU within the soft tissue attenuating peripheral component is approximately 66, probably representing residual hemorrhage. 

The proximal ureter is displaced anteromedially resulting in hydronephrosis and proximal hydroureter. 

Case Discussion

This case illustrates the most common complication of large angiomyolipomas: spontaneous retroperitoneal haemorrhage. 

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Case information

rID: 13311
Case created: 25th Mar 2011
Last edited: 23rd Jan 2016
Inclusion in quiz mode: Included

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