MedPix® Patient Chart - Case No: 13039 :: - Review Images

Evaluation of incidentally discovered kidney mass.

Normal at time of CT

- Review Images for PT: 13039

Partially exophitic, enhancing mass with macroscopic fat.

- Review Images for PT: 13039

Angiomyolipoma
Renal cell carcinoma with sequestered fat

- Review Images for PT: 13039

Dx: angiomyolipoma

Dx Confirmed by: Remains a differential case with AML strongly favored

- Read

Unless there is a strong clinical suspicion of malignancy, this can be followed radiographically to ensure stability.

Angiomyolipoma (AML)
• Hamartoma
» Fat, smooth muscle, blood vessels
• May bleed if >4cm
» Smaller lesions are not treated
• Typically enhance strongly
» Predominantly myxomatous AMLs may be hypovascular
• Strong association of Tuberous Sclerosis: 80% of Tuberous Sclerosis patients have mutliple AML's, usually bilateral

Radiographic Features
• Presence of fat is virtually diagnostic
» Case reports of Renal Cell Carcinoma with sequestered fat, make sure fat is not from renal pelvis
• No calcifications
• Variable appearance
» Predominance of vessel-T2 bright, strong enhancement
» Predominance of muscle-looks like Renal cell carcinoma