期刊论文详细信息
BMC Nephrology
Calcified, minimally Fat-contained angiomyolipoma clinically indistinguishable from a renal cell carcinoma
Tai-Lung Cha1  Sun-Yran Chang1  Dah-Shyong Yu1  Guang-Huan Sun1  Chih-Wei Tsao1  En Meng1  Sheng-Tang Wu1  Shou-Hung Tang1  Chin-Li Chen1 
[1] Division of Urology, Department of Surgery, Tri-Service General Hospital, No.325, Section 2, Cheng-Kung Road, Taipei 114, Taiwan, R.O.C
关键词: Renal cell carcinoma;    Radical nephrectomy;    Calcifications;    Angiomyolipoma;   
Others  :  1082879
DOI  :  10.1186/1471-2369-14-160
 received in 2012-09-30, accepted in 2013-07-08,  发布年份 2013
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【 摘 要 】

Background

Angiomyolipomas are benign tumors of the kidney. Typical angiomyolipomas are usually recognized by identifying fat components before any intervention. On the contrary, solid renal masses without evident fatty components but containing calcifications on the computed tomography scan are suspicious for malignancy. However, as in this rare case, rules of diagnostic imaging are of exceptions.

Case presentation

A 40-year-old man presented with left flank pain. The plain X-ray showed multiple coarse calcifications of 4.0 x 3.2 cm in diameter on the left upper quadrant abdomen. Computed tomography scan further revealed a solid renal mass and inside the mass there were calcifications. The size of the tumor was 5.6 × 5.5 × 6.3 cm. We performed a radical nephrectomy, and the histopathology showed a minimally fat-contained angiomyolipoma of multiple calcifications. The patient was free of recurrence or metastases after a follow-up period of 3 years.

Conclusion

An angiomyolipoma containing calcification is rare. An angiomyolipoma with minimal fat concomitant with calcifications is an even rarer presentation. It is very difficult to differentiate a minimal-fat angiomyolipoma with calcifications from a renal cell carcinoma preoperatively. In such a circumstance, a well-planned partial nephrectomy may be optimal for the patient, regardless of the tumor size.

【 授权许可】

   
2013 Chen et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Helenon O, Merran S, Paraf F, Melki P, Correas JM, Chretien Y, Moreau JF: Unusual fat-containing tumors of the kidney: a diagnostic dilemma. Radiographics 1997, 17(1):129-144.
  • [2]Ozeki Y, Matsumoto K, Goto M, Hayashi M, Onitsuka A, Hirose M, Shimokawa K: A case of renal angiomyolipoma with bone formation. Nihon Geka Gakkai zasshi 1988, 89(3):458-463.
  • [3]Merran S, Vieillefond A, Peyromaure M, Dupuy C: Renal angiomyolipoma with calcification: CT-pathology correlation. Br J Radiol 2004, 77(921):782-783.
  • [4]Hammadeh MY: Calcification within angiomyolipoma. Radiographics 1998, 18(1):4.
  • [5]Deeths TM, Melson GL: Calcification in an angiomyolipoma: a case report. J Urol 1975, 114(4):613-614.
  • [6]Patterson J, Lohr D, Briscoe C, Briscoe G, Flanigan RC: Calcified renal masses. Urology 1987, 29(4):353-356.
  • [7]Hajdu SI, Foote FW Jr: Angiomyolipoma of the kidney: report of 27 cases and review of the literature. J Urol 1969, 102(4):396-401.
  • [8]Tanaka H, Yoshida S, Fujii Y, Ishii C, Koga F, Saito K, Masuda H, Kawakami S, Kihara K: Diffusion-weighted magnetic resonance imaging in the differentiation of angiomyolipoma with minimal fat from clear cell renal cell carcinoma. Int J Urol 2011, 18(10):727-730.
  • [9]Fujii Y, Komai Y, Saito K, Iimura Y, Yonese J, Kawakami S, Ishikawa Y, Kumagai J, Kihara K, Fukui I: Incidence of benign pathologic lesions at partial nephrectomy for presumed RCC renal masses: japanese dual-center experience with 176 consecutive patients. Urology 2008, 72(3):598-602.
  • [10]Shrewsberry AB, Sica GL, Osunkoya AO, Canter DJ: Epithelioid PEComa (epithelioid angiomyolipoma) of the kidney: a rare tumor subtype for patients presenting with an enhancing renal mass. Can J Urol 2013, 20(1):6643-6645.
  • [11]Froemming AT, Boland J, Cheville J, Takahashi N, Kawashima A: Renal epithelioid angiomyolipoma: imaging characteristics in nine cases with radiologic-pathologic correlation and review of the literature. AJR Am J Roentgenol 2013, 200(2):W178-W186.
  • [12]Schuster TG, Ferguson MR, Baker DE, Schaldenbrand JD, Solomon MH: Papillary renal cell carcinoma containing fat without calcification mimicking angiomyolipoma on CT. AJR Am J Roentgenol 2004, 183(5):1402-1404.
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