Renal angiomyolipoma with aggressive features and inferior vena cava extension
Presentation
Intermittent abdominal pain for 2 months
Patient Data
Predominantly endophytic fat-attenuating mass in the interpolar region, extending into the renal sinus, with an exophytic component medially to the renal hilum of the right kidney. A small portion of the mass extends into the main renal vein, and into the infrahepatic inferior vena cava, minimally occluding its lumen. The mass shows minimal contrast enhancement in some of its portions with some visible vessels. The mass is measuring approximately 6.3 x 4.7 x 6.0 cm (CCx ML x AP). It is intimately related to and compresses the superior and middle calyces and renal pelvis, with no intraluminal extension.
Case Discussion
Renal angiomyolipomas typically present as benign lesions without local invasion. However, they may occasionally exhibit aggressive behavior. Intravascular extension into the inferior vena cava (IVC) and hemorrhagic aneurysm formation associated with AML has rarely been reported in the past.