Kheir Pietro, Abdessater Maher, El Khoury Joey, Akiel Rody, El Hachem Charbel, Tawil Nabil, El Khoury Rahgid
Department of Cardiovascular Surgery, Notre Dame des Secours University Hospital Center, Byblos City, Lebanon; Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
Departent of Urology, Notre Dame des Secours University Hospital Center, Byblos City, Lebanon; Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
Int J Surg Case Rep. 2020;70:149-153. doi: 10.1016/j.ijscr.2020.04.076. Epub 2020 May 8.
Renal angiomyolipomas (AML) are often regarded as benign tumors. This article reports the case of a 47 year old patient with AML associated with a venous invasion of the inferior vena cava.
Our 47 year old male patient presented for flank pain and hematuria. CT Scan revealed a 3 cm lobulated low-density lesion in the renal sinus, middle and upper lobes of the right kidney, with evidence of IVC thrombus on angioscan. Right radical nephrectomy and thrombectomy were successfully done with use of cardiopulmonary bypass. On pathology, AML was confirmed.
Renal AML are unilateral and sporadic in most cases, with a female predominance. The occurrence of venous invasion in patients with AML is a rare and unique phenomenon. CT scan is the imaging of choice in such cases and surgery remains the optimal treatment.
More focus should be put on the ability of AML to invade venous structures. Early imaging and therapeutic planning are necessary for the best outcome in case of vena cava invasion. Collaboration of the urologist with the vascular surgeon can lead to better surgical results.
肾血管平滑肌脂肪瘤（AML）通常被视为良性肿瘤。本文报告了一例47岁的AML患者，伴有下腔静脉静脉侵犯。
我们的47岁男性患者因侧腹痛和血尿就诊。CT扫描显示右肾肾窦、中上部有一个3厘米分叶状低密度病变，血管造影显示有下腔静脉血栓形成。在体外循环辅助下成功实施了右肾根治性切除术和血栓切除术。病理检查确诊为AML。
大多数情况下，肾AML是单侧且散发性的，女性居多。AML患者发生静脉侵犯是一种罕见且独特的现象。CT扫描是此类病例的首选影像学检查，手术仍是最佳治疗方法。
应更多关注AML侵犯静脉结构的能力。对于下腔静脉侵犯的情况，早期影像学检查和治疗规划对于取得最佳结果是必要的。泌尿外科医生与血管外科医生的合作可带来更好的手术效果。
