Melo Abreu Elisa, Cunha Teresa Margarida
Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal.
BJR Case Rep. 2016 Feb 19;2(2):20150218. doi: 10.1259/bjrcr.20150218. eCollection 2016.
A 66-year-old female with history of endometrioid endometrial carcinoma was admitted to our institution with abdominal and pelvic pain. A CT scan revealed a mass within the right upper kidney with a tumour thrombus that extended through the right renal vein up to the point of confluence with the inferior vena cava (IVC). The imaging features of the mass strongly suggested a diagnosis of renal angiomyolipoma (AML) with renal vein thrombosis. The patient was proposed an open radical right nephrectomy with right renal thrombectomy for histopathological confirmation of the diagnosis of AML with extension to the right renal vein and preventing complications such as potentially fatal pulmonary thromboembolism. The implantation of a temporary IVC filter before surgery was recommended.
一名66岁患有子宫内膜样子宫内膜癌的女性因腹部和盆腔疼痛入住我院。CT扫描显示右肾上极有一肿块,伴有肿瘤血栓,血栓延伸至右肾静脉直至与下腔静脉汇合处。肿块的影像学特征强烈提示诊断为肾血管平滑肌脂肪瘤(AML)伴肾静脉血栓形成。建议对该患者行开放性右肾根治性切除术及右肾血栓切除术,以对AML累及右肾静脉的诊断进行组织病理学确认,并预防潜在致命性肺血栓栓塞等并发症。建议在手术前植入临时下腔静脉滤器。