DIAGNOSTIC VALUE OF MULTI-SLICE CT SCAN FOR RENAL ANGIO- MYOLIPOMA DETECTION: A CASE REPORT

Kevin Wenardi

Abstract


Background: Angiomyolipoma (AML) is a rare solid benign tumor that occurs at many sites, more commonly in the kidney, which arises from either the renal pelvis or the sinus, also referred to as renal hamartoma. AML is composed of blood vessels, smooth muscle cells, and fat hence the name. They are seen 80-90% as isolated lesions that occur sporadically and seen 25-50% of patients with tuberous sclerosis. AML may hard to be distinguished from renal cell carcinoma because of its presentation as enlarged lump. Computed tomography may help to diagnose AML. To get a definite diagnosis of AML, excision and histopathological examination is recommended in symptomatic patients, especially to prevent rupture hemorrhage. Objective: The purpose of this study was to evaluate multi-slice computed tomography with contrast in a male patient aged 49 years with Angiomyolipoma Case description: We herein present a case of renal AML in a 49 years old male patient, who presented with left flank pain for ~1 year. He has no history of hematuria and dysuria and tuberous sclerosis. Multi-slice computed tomography with contrast demonstrates a hypodense inhomogenous mass measuring 11x9,3 cm in the upper pole of the left kidney, hypertrophy of the left kidney, and hump sign of left kidney. At the later date, the patient underwent total left nephrectomy at another hospital and the postoperative histopathological examination confirmed the lesion as an AML. Conclusion: Angiomyolipoma is a rare benign tumor which usually occurs in the kidney that can be confused with malignant tumor. Ultrasonography and computed tomography can help to diagnose AML. The symptomatic patient requires surgical intervention.

Keywords


angiomyolipoma, kidney, multidetector computed tomography, flank pain

Full Text:

PDF

References


Oken, Laishram Singh, Sapam Opendro Singh, Chinglaiphaba Chongtham, Chetan Maibam, Th. Sudhirchandra Singh. Renal Angiomyolipoma: A case report. 2016. International Journal of Research in Health Sciences, Volume-4, Issue-3. Available from: https://ijrhs.org/article/2016/4/3-1 [Accessed 30 October 2020].

Chen, Peijie, Lu Jin, Yu Yang, Zebo Chen, Liangchao Ni, Shanqi Yang, and Yongqing Lai. Giant renal angiomyolipoma: A case report. 2017. Molecular and Clinical Oncology, 7: 298-300. DOI: 10.3892/mco.2017.1305.

Saber, Mohamed and Behrang Amini, et al. Renal Angiomyolipoma. 2019. Available from: https://radiopaedia.org/articles/renal-angiomyolipoma [Accessed 30 October 2020].

Nawaz, Ali Khan. Renal Angiomyolipoma Imaging. 2019. Available from: https://emedicine.medscape.com/article/376848-overview [Accessed 30 October 2020].

Reinhard, Rinze, Mandy van der Zon-Conijn, and Robin Smithuis. Solid masses. 2016. Available from: https://radiologyassistant.nl/abdomen/kidney/solid-masses [Accessed 30 October 2020].

Meraj R, Wikenheiser-Brokamp KA, Young LR, McCormack FX. Lymphangioleiomyomatosis: new concepts in pathogenesis, diagnosis, and treatment. 2012. Seminars in respiratory and critical care medicine; 33(5):486-497. DOI: 10.1055/s-0032-1325159.

Cui L, Zhang JG, Hu XY et-al. CT imaging and histopathological features of renal epithelioid angiomyolipomas. 2012. Clin Radiol; 67(12):e77-82. DOI: 10.1016/j.crad.2012.08.006.

Malhi H, Grant EG, Duddalwar V. Contrast-Enhanced Ultrasound of the Liver and Kidney. 2014. Radiol. Clin. North Am.; 52(6):1177-1190. DOI: 10.1016/j.rcl.2014.07.005.

Shetty AS, Sipe AL, Zulfiqar M, Tsai R, Raptis DA, Raptis CA, Bhalla S. In-Phase and Opposed-Phase Imaging: Applications of Chemical Shift and Magnetic Susceptibility in the Chest and Abdomen. 2019. Radiographics: a review publication of the Radiological Society of North America, Inc. 39(1):115-135. DOI: 10.1148/rg.2019180043.

Maclean DF, Sultana R, Radwan R et-al. Is the follow-up of small renal angiomyolipomas a necessary precaution?. 2014. Clin Radiol; 69(8):822-826. DOI: 10.1016/j.crad.2014.03.016.

Dawson C. Guidelines for the active surveillance of angiomyolipoma. 2017. Urology Clinical Governance Lead. Available from: http://www.pchurology.co.uk/governance/AML%202017.pdf [Accessed 30 October 2020].

Dickson MA, Schwartz GK, Antonescu CR, Kwiatkowski DJ, and Malinowsska IA. Extrarenal perivascular epithelioid cell tumors (PEComas) respond to mTOR inhibition: molecular correlates. 2013. International Journal of Cancer; 132(7):1711-1717. DOI: 10.1002/ijc.27800.

Shitara K, Yatabe Y, Mizota A, Sano T, Nimura Y, Muro K. Dramatic tumor response to everolimus for malignant epithelioid angiomyolipoma. 2011. Japanese Journal of Clinical Oncology; 41(6):814-816. DOI: https://doi.org/10.1093/jjco/hyr035.




DOI: http://dx.doi.org/10.21460/bikdw.v6i1.226

Refbacks

  • There are currently no refbacks.


Copyright (c) 2022 Berkala Ilmiah Kedokteran Duta Wacana

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.