Renal Angiomyolipoma Associated with Renal Vein and Inferior Vena Cava Thrombosis: A Case Report

R. Mohammadi, A. Kamalati, Mohammadali Bagherinasabsarab, E. Jafari, Fatemeh Yazdanpanah
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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.
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肾血管平滑肌脂肪瘤伴肾静脉和下腔静脉血栓形成1例报告
血管平滑肌脂肪瘤(AML)是最常见的良性肾间质肿瘤。本文报告一位36岁女性急性髓性白血病伴下腔静脉(IVC)受累住院。病人主诉有轻微的右侧疼痛。CT扫描结果显示右肾下极低密度肿块,尺寸为47×72 mm,提示肾性AML。MRI造影示右肾静脉及下腔静脉血栓形成。成功行右侧根治性肾切除术及下腔静脉血栓切除术。病理证实为肾性AML,右肾静脉及下腔静脉均有肿瘤血栓形成。虽然AML通常是良性的,并且在这种情况下很少发现血管侵犯,但影像学检查(包括CT扫描)应始终考虑确定血管受累程度并选择适当的治疗方案,包括血管受累时的肾切除术和血栓切除术。尽管它是良性的,但应该考虑到AML可以侵入肾脏的静脉结构。早期影像学检查和治疗干预是获得最佳结果的必要条件。
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