Renal angiomyolipoma

Case contributed by RMH Report Writing

Presentation

Hypotensive.

Patient Data

Age: 38-year-old
Gender: Female
CT

CT KUB

 

Heterogeneous fat containing rounded exophytic mass extending from the upper pole of the right kidney measuring 11.7 x 10.7 x 15.4 cm. This is most in keeping with an angiomyolipoma which was seen on previous abdominal ultrasound. The angiomyolipoma demonstrates internal density consistent with haematoma and haematoma also seen in the right pararenal space extending particularly posterior and inferior to the kidney, the largest portion measuring approximately 8.7 x 3.2 x 6.6 cm.

The right kidney is displaced anteriorly and inferiorly as have the gallbladder and pancreatic head. The IVC is partially compressed.

A small amount of free fluid seen around the liver.

No renal calculus. No calculi are seen in the path of the ureters.

The liver, spleen, left adrenal gland and bowel are unremarkable. The right adrenal gland is not well discerned.

No free intra-abdominal air identified. Two 5 mm pulmonary nodule seen in the lateral left lower lobe. These could be followed up with outpatient CT chest.

Conclusion: 15 cm angiomyolipoma is seen extending from the upper pole of the right kidney with evidence of acute bleed with internal haematoma and retroperitoneal haematoma. 

Case Discussion

CT features are those of a bleeding AML. DSA with embolisation was performed.

There were no features of tuberous sclerosis in this patient.

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Case information

rID: 39049
Case created: 17th Aug 2015
Last edited: 17th Jun 2017
System: Urogenital
Tag: rmh
Inclusion in quiz mode: Included

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