Giant renal angiomyolipoma with adrenal myelolipoma and adrenal adenoma
Presentation
Abdominal pain.
Patient Data
There is well-defined exophytic predominantly macroscopic fat attenuation lesion, mostly arising from the upper pole of right kidney. It contains few vascular structures as well as small soft tissue component. The lesion exerting mass effect upon the duodenum. Appearances are most likely representing renal angiomyolipoma.
Another large well-defined right sided retroperitoneal lesion, which shows predominantly fat attenuation areas interspersed with area of higher attenuation. No definite invasion on the surrounding structures. Appearances are most likely representing adrenal myelolipoma.
Left adrenal gland well defined hypodense lesion with average attenuation of less than -15 H.U. on pre-contrast study. Appearances are most likely representing adrenal Adenoma.
No evidence of retroperitoneal hemorrhage.
Case Discussion
Radiologic features are most likely in keeping with right renal giant angiomyolipoma, right adrenal myelolipoma and left adrenal adenoma.
Adrenal myelolipoma and renal angiomyolipoma have a higher risk of bleeding when they are large in size, which can lead to retroperitoneal hemorrhage that requires emergent intervention.
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