Spontaneous Rupture of Large Angiomyolipoma of the Kidney: A Rare Case

Abstract

Angiomyolipoma is the most frequent neoplasm of the kidney. It may have a wide range of clinical manifestations, but it is usually detected incidentally on cross-sectional images. Rupture and hemorrhage of angiomyolipoma is an important concern for large lesions. We present the case of a 42-year-old female, with no history of urinary stones, who presented with a sudden-onset left flank pain for eight hours. Upon examination, she was tachycardic and hypotensive. Abdominal examination revealed a left-sided flank mass. Abdominal computed tomography (CT) scan with intravenous contrast demonstrated a heterogeneous mass lesion in the left kidney with mixed attenuation and had a macroscopic fat density that was surrounded by a large hematoma. Subsequently, transcatheter renal artery embolization was performed with no complications. The procedure was able to control the active bleeding. Then, a total nephrectomy was performed, and the hematoma was evacuated during laparotomy. Spontaneous nontraumatic renal hemorrhage is a very rare condition. Clinicians should keep a high index of suspicion for this condition when they encounter a patient with the clinical triad of flank pain, flank mass, and hypotension. The case demonstrated the role of endovascular embolization of angiomyolipoma to control life-threatening hemorrhage.

Paralytic Ileus as a Presentation of Antiphospholipid Syndrome in a Patient with Renal Angiomyolipoma: A Case Report

“…Findings on the pre-contrast CT scan were bilateral AML and a subcapsular hematoma with suspected ongoing bleeding in the right kidney. It has been reported that a common cause of spontaneous subcapsular hematoma is AML [7] which is the most typical benign solid kidney tumor. AML contains blood vessels, spindle cells, and fatty tissues.…”

“…AML is one of the most common types of kidney tumor. It consists of muscle, fat, and blood vessels, so it is prone to bleeding [7,8]. Hence, we report a unique case of a 42-yearold man who suffered from paralytic ileus as a presentation of APS and the challenging anticoagulant therapy due to ongoing bleeding renal AML.…”

Wunderlichov sindrom kao prva manifestacija karcinoma bubrega

“…Angiomiolipom je najčešća benigna neoplazma koja može biti uzrokom ovoga sindroma, pogotovo kada je veći od četiri centimetra. Angiomiolipom se u 80 % bolesnika javlja sporadično, dok kod ostalih 20 % bolesnika može biti povezan s mutacijama u genima TSC1 i TSC2 5 . Kod tumora koji su veći od 4 cm, postoji veća mogućnost stvaranja aneurizama unutar lezije, a time i mogućnost krvarenja što je opisano kod većine pacijenata s Wunderlichovim sindromom 6 .…”

Management of Nontraumatic Spontaneous Renal Hemorrhage (Wünderlich Syndrome) through Robotic-Assisted Laparoscopic Nephrectomy: A Case Series

“…Tumor rupture, particularly in angiomyolipomas (AML) and renal cell carcinomas (RCC), is the primary cause of WS [ 6 ]. Non-tumor causes include infections, coagulation disorders, stone disease, and vascular factors, such as vasculitis, arteriovenous malformations, renal vein thrombosis, and renal aneurysms [ 7 ].…”