腎部分切除術を施行し残腎機能を保ち得た腎血管筋脂肪腫の1例

Abstract

A 25-year-old female was admitted for further investigation of the right renal mass, which was noted during evaluation for hepatitis. She had no personal or family history of stigmas of tuberous sclerosis. On physical examination, a movable hard smooth mass of fist size was palpable in the right abdomen. Drip infusion pyelography revealed an elevation of right kidney. Ultrasonography revealed that the abdominal mass had a high amplitude echo area. On CT the mass was heterogeneous with irregular margin and had regions of low attenuation value, suspicious of a tumor with high fat content. An angiogram of the right renal artery revealed a hypervascular tumor showing multiple saccular aneurysms, and absence of arteriovenous shunting. Based on the aforementioned findings, the mass was diagnosed as renal angiomyolipoma. Partial right nephrectomy was performed through an extraperitoneal approach. Pathological diagnosis was a renal angiomyolipoma. Convalescence was uneventful, and the remaining parenchyma of right kidney was working well on drip infusion pyelography three months after operation. The management of renal angiomyolipoma from the conservative point of view is also discussed.