Anomalous Presentation of a Renal Angiomyolipoma

Angiomyolipoma (AML) of the kidney is a benign hamartomatous neoplasm which is usually asymptomatic and picked up incidentally on radiological imaging. AMLs that present symptomatically are typically those of large sizes exceeding 4cm with complications of rupture and retroperitoneal bleed. The classical triad in symptomatic cases includes flank pain, flank mass and gross haematuria. In cases of severe hemorrhage, patients may even turn hypotensive. AMLs rarely present as fever or urinary tract infection. This report presents a case of a middle-aged lady who presented with fever and lower urinary tract symptoms, and urinary studies performed were suggestive of a urinary tract infection. Radiological investigations revealed a right sided renal AML. This report discusses how renal AMLs can present atypically and includes a review of literature.