Hemorrhagic renal angiomyolipoma

Case contributed by Assis Prof Faeze Salahshour

Presentation

History of seizure, acute RUQ pain

Patient Data

Age: 25 years
Gender: Female

Multiple variable size fat density renal masses with enlarged vasculature are visible bilaterally in favor of bilateral renal angiomyolipomas. A hematoma is seen in the right perinephric space, deviating the right kidney anteromedially. The hematoma is due to hemorrhage of the largest angiomyolipoma of the right kidney. The hematoma extends to the combined retroperitoneal fascia, and mild to moderate free fluid with a fluid-fluid level is seen in the pelvis. Evidence of the previous cholecystectomy is seen.

On lower thoracic CT images, several small pulmonary cysts are visible with LAM's possibility in the context of tuberous sclerosis.

Case Discussion

The patient likely is a case of tuberous sclerosis considering history of seizure and pulmonary cysts but the brain MRI was not available. She underwent trans-arterial embolization of the hemorrhagic mass.

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Case information

rID: 83349
Published: 20th Oct 2020
Last edited: 24th Oct 2020
System: Urogenital
Inclusion in quiz mode: Included
Institution: Tehran University of Medical Sciences (TUMS)