Al Sheikh Mohammed, Simson Nick, Obi-Njoku Obinna, Qteishat Ahmed
Department of Urology, Princess Alexandra Hospital NHS Trust, Harlow, UK.
BMJ Case Rep. 2018 Feb 8;2018:bcr-2017-222737. doi: 10.1136/bcr-2017-222737.
A previously healthy 61-year-old Caucasian woman presented to the emergency department after collapsing at home with associated abdominal pain radiating to her back. An urgent CT angiogram was requested to rule out a ruptured aortic aneurysm. This showed a large 21 cm fat-containing lesion arising from the mid-pole of the left kidney, with an adjacent 4 cm perirenal haematoma. An initial diagnosis of a ruptured angiomyolipoma was made. Her haemoglobin was 105 g/L, with a creatinine of 104 mmol/L and an eGFR of 47 mL/min. Her clotting profile was normal. Following resuscitation, she was taken to the operating room and underwent an emergency open left radical nephrectomy via a left flank incision. Her recovery was uneventful and she was discharged home after 6 days. The histopathology confirmed a well-differentiated liposarcoma.
一名61岁此前身体健康的白人女性在家中晕倒并伴有腹痛放射至背部后被送往急诊科。请求进行紧急CT血管造影以排除主动脉瘤破裂。检查显示左肾中极有一个21厘米的含脂肪大肿块，伴有一个4厘米的肾周血肿。初步诊断为破裂的血管平滑肌脂肪瘤。她的血红蛋白为105g/L，肌酐为104mmol/L，估算肾小球滤过率（eGFR）为47mL/min。她的凝血指标正常。复苏后，她被送往手术室，通过左腰部切口接受了急诊开放性左肾根治性切除术。她恢复顺利，6天后出院。组织病理学证实为高分化脂肪肉瘤。
