Document Type : Case Report
Authors
- Reza Mohammadi 1
- Ali Kamalati 1
- Mohammadali Bagherinasabsarab 1
- Elham Jafari 2
- Fatemeh Yazdanpanah 3
1 Department of Urology, Kerman University Medical Sciences, Kerman, Iran
2 Pathology and Stem Cell Research Center, Pathology department, Kerman University of Medical Science, Kerman, Iran
3 Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
Abstract
Abstract
Angiomyolipoma (AML) is the most common benign renal mesenchymal neoplasm. This is a report of a 36-year-old female patient with AML with the involvement of the inferior vena cava (IVC) who was admitted to our hospital. The patient complained of mild right flank pain. CT scan results showed a hypo-dense mass with 47 × 72 mm dimensions at the right kidney›s lower pole suggesting renal AML. In MRI with contrast, venous thrombosis was detected in the right renal vein and IVC. Right radical nephrectomy and IVC thrombectomy were successfully conducted. Renal AML was confirmed by pathological findings, and the presence of tumor thrombosis was approved in the right renal vein and IVC. Although AML is generally benign and vascular invasion is a rare finding in this condition, imaging studies (including CT scans) should always be considered to determine the extent of vascular involvement and choose an appropriate therapeutic plan, including nephrectomy and thrombectomy in case of vascular involvement. Despite its benign nature, it should be considered that AML can invade venous structures in the kidneys. Early imaging studies and therapeutic interventions are necessary for obtaining the best outcome.
Keywords
- Yarmish G, DiPoce J. Case 199: Aggressive angiomyolipoma with renal vein thrombosis and pulmonary fat embolus. Radiology. 2013;269(2):615-8. doi: 10.1148/ radiol.13121187.
- Partin AW, Peters CA, Kavoussi LR, Dmochowski RR, Wein AJ. Campbell-Walsh-Wein Urology Twelfth Edition Review E-Book. 12th ed. Elsevier Health Sciences; 2020.p. 2125-8.
- Haritharan T, Sritharan S, Bhimji S. Renal angiomyolipoma with inferior vena caval involvement. Med J Malaysia. 2006;61(4):493-5.
- Durand X, Renard-Penna R, Comperat E, Bitker MO, Richard F. Renal angiomyolipoma associated with inferior vena cava thrombus. Case Rep Med. 2009;2009:789078. doi: 10.1155/2009/789078.
- Agha RA, Borrelli MR, Farwana R, Koshy K, Fowler AJ, Orgill DP. The SCARE 2018 statement: updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg. 2018;60:132-6. doi: 10.1016/j.ijsu.2018.10.028.
- Kheir P, Abdessater M, El Khoury J, Akiel R, El Hachem C, Tawil N, et al. Renal angiomyolipoma with IVC thrombus: a case report. Int J Surg Case Rep. 2020;70:149-53. doi: 10.1016/j.ijscr.2020.04.076.
- Webb DW, Kabala J, Osborne JP. A population study of renal disease in patients with tuberous sclerosis. Br J Urol. 1994;74(2):151-4. doi: 10.1111/j.1464-410x.1994. tb16577.x.
- Islam AH, Ehara T, Kato H, Hayama M, Kashiwabara T, Nishizawa O. Angiomyolipoma of kidney involving the inferior vena cava. Int J Urol. 2004;11(10):897-902. doi: 10.1111/j.1442-2042.2004.00909.x.
- Shao N, Wang HK, Zhu Y, Ye DW. Modification of American Joint Committee on Cancer prognostic groups for renal cell carcinoma. Cancer Med. 2018;7(11):5431-8. doi: 10.1002/ cam4.1790.
- Mandhani A, Patidar N, Aga P, Pande S, Tewari P. A new classification of inferior vena cava thrombus in renal cell carcinoma could define the need for cardiopulmonary or venovenous bypass. Indian J Urol. 2015;31(4):327-32. doi: 10.4103/0970-1591.166459.
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