Spontaneous rupture of renal angiomyolipoma in twin pregnancy, surgical management with fetal preservation: a case report

Abstract

Introduction: Renal Angiomyolipomas are rare in pregnancy.They have tendency to grow in size leads to rupture and occasionally fatal because of hormonal imbalance. Our case report is aim to report the management strategy during first week of pregnancy. Case presentation: A 29 years female presented in her 11 weeks of gestation following ovulation induction with right flank pain which increased in severity recently.Radiological scans revealed 16x12 cm expanding mass suggestive of ruptured right renal AML. We have managed with a multidisciplinary approach and right open nephrectomy was performed in lieu of symptoms with serial ultrasound showed increased retroperitoneal collection in size. The histopathology revealed renal angiomyolipoma. On table and postoperative obstetrics scan revealed two live fetuses without any stress. Letter cesarean section was performed at 35 weeks without any complications. Conclusion: Ruptured renal angiomyolipoma is rarer with twin pregnancy.Multidisciplinary approach resulted in successful nephrectomy without concurrent delivery, allowing the pregnancy to proceed to term.