Presentation
Acute abdomen with nausea, vomiting and severe pain.
Patient Data
Retroperitoneal hemorrhage. “Hyper-attenuating retroperitoneal hemorrhage in continuity with 4cm fat-containing tumor arising from the left kidney. Minor focal active bleeding demonstrated following contrast. There's a cyst in 4th hepatic segment; another cyst in the upper pole of the left kidney. Calcific pleuropathy in the left pleural cavity. At the sigmoid level presence of diverticula in the absence of complications.
Little active bleeding point (yellow arrow) and acute hemorrhage due to rupture of left renal angiomyolipoma.
Case Discussion
Renal angiomyolipoma is a benign neoplasm of the kidney, and is the most common renal tumor associated with hemorrhage. On CT, angiomyolipomas appear to have well defined margins, with a variable proportion of fat and soft tissue. Risk of bleeding increases with the size of the angiomyolipoma. There is a 13% risk of bleeding if the lesion is < 4 cm and a 51% risk if > 4 cm.
Case courtesy Dr.ssa Luisa Coletta
Radiographer: TSRM Fabio Imola
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