Department of Radiology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Dec 28;47(12):1763-1768. doi: 10.11817/j.issn.1672-7347.2022.220044.
Renal angiomyolipoma (AML) with renal vein, inferior vena cava (IVC), and right atrial embolism is a rare solid tumor, whose etiology and pathogenesis are still unclear. Moreover, it is often misdiagnosed. One patient with renal AML complicated with renal vein, IVC, and right atrial embolism was admitted to the Second Xiangya Hospital of Central South University, who was a 35-year-old female, without any previous medical history, presented with right low back pain for more than 3 years. Computed tomography (CT) scan showed irregular lobulated fatty density mass in the right kidney, renal vein, IVC, and right atrium. The contrast-enhanced scan showed no enhancement of fat components at each phase and mild enhancement of solid components. Radical resection of the right kidney and removal of tumor thrombus were performed, and there was no recurrence 1 year after the operation. It is rare for renal AML to grow along the renal vein, IVC, and extend to the right atrium. Imaging examination is extremely important, and the CT findings of this case are characteristic, but the diagnosis eventually depends on pathological and immunohistochemical examinations.
肾血管平滑肌脂肪瘤(AML)合并肾静脉、下腔静脉(IVC)和右心房栓塞是一种罕见的实体肿瘤,其病因和发病机制尚不清楚。此外,它常被误诊。中南大学湘雅二医院收治了 1 例肾 AML 合并肾静脉、IVC 和右心房栓塞的患者,为 35 岁女性,无既往病史,表现为右腰痛 3 年余。CT 扫描显示右肾、肾静脉、IVC 和右心房不规则分叶状脂肪密度肿块。增强扫描各期均未见脂肪成分增强,实性成分轻度增强。行右肾癌根治性切除术及肿瘤栓子取出术,术后 1 年无复发。肾 AML 沿肾静脉、IVC 生长并延伸至右心房较为罕见。影像学检查极为重要,本例 CT 表现具有特征性,但最终诊断仍依赖于病理和免疫组化检查。