Heterogeneous fat containing rounded exophytic mass extending off the upper pole of the right kidney measuring 11.7 x 10.7 x 15.4 cm. The angiomyolipoma demonstrates internal density consistent with haematoma and haematoma also seen in the right pararenal space extending particularly posterior and inferior to the kidney, the largest portion measuring approximately 8.7 x 3.2 x 6.6 cm. The right kidney is displaced anteriorly and inferiorly as have the gallbladder and pancreatic head. The IVC is partially compressed. Small amount of free fluid seen around the liver. No renal calculus. No calculi seen in the path of the ureters. The liver, spleen, left adrenal gland and bowel are unremarkable. The right adrenal gland is not well discerned.
Contrast blush is seen on the delayed phase images in multiple places on the
lateral margin of the angiomyolipoma (seen on thin sections, not shown). Assessment for active extravasation in the centre of the lesion is
difficult given the small calibre arteries.
The IVC is displaced anteriorly and compressed by mass-effect from essentially complete effacement at the T12/L1 level extending to the region of hepatic vein insertion.
Non-occlusive filling defects are seen within the left renal vein, superior azygos vein, left common iliac vein and inferior IVC.