Presentation
Right upper quadrant pain. An incidental finding was discovered on an ultrasound exam. An MRI was requested for characterization and location.
Patient Data
Large hyperechoic mass of interhepatorenal location, arising probably from the renal cortex with posterior acoustic shadowing and internal vascularity on color Doppler.
A well-defined exophytic mass arising from the posterolateral aspect of the right kidney and extending to the perirenal space. It shows two components, the main component is of high signal on T1 and T2 (isointense to the retroperitoneal fat) and attenuated on fat sat sequences (fatty component). The non-fatty component is of low signal on T1, high signal on T2 and T2 fat sat with no restricted diffusion and progressive enhancement on postcontrast sequences.
Two gallstones are noted.
Case Discussion
The ultrasound and the MRI features are most consistent with renal angiomyolipoma.
Angiomyolipomas are the most common fat-containing lesions of the kidneys and the most common benign solid renal lesion. The majority of angiomyolipomas are sporadic (80%) and are typically identified in adults (mean age of presentation 43 years), the remaining 20% are seen in association with phakomatoses.
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