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肾上皮样血管平滑肌脂肪瘤自发性破裂出血误诊为肾癌 1 例报告。

Spontaneous rupture and hemorrhage of renal epithelioid angiomyolipoma misdiagnosed to renal carcinoma: a case report.

机构信息

Department of Urology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, 310006, Zhejiang, People's Republic of China.

Department of Pathology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, 310006, Zhejiang, People's Republic of China.

出版信息

J Med Case Rep. 2024 Sep 12;18(1):425. doi: 10.1186/s13256-024-04743-5.

Abstract

BACKGROUND

Renal epithelioid angiomyolipoma is a rare and unique subtype of classic angiomyolipoma, characterized by the presence of epithelioid cells. It often presents with nonspecific symptoms and can be easily misdiagnosed due to its similarity to renal cell carcinoma and classic angiomyolipoma in clinical and radiological features. This case report is significant for its demonstration of the challenges in diagnosing epithelioid angiomyolipoma and its emphasis on the importance of accurate differentiation from renal cell carcinoma and classic angiomyolipoma.

CASE PRESENTATION

A 58-year-old Asian female presented with sudden left flank pain and was initially diagnosed with a malignant renal tumor based on imaging studies. She underwent laparoscopic radical nephrectomy, and postoperative histopathology confirmed the diagnosis of epithelioid angiomyolipoma. The patient recovered well and is currently in good health with regular follow-ups. This case highlights the diagnostic challenges, with a focus on the clinical, radiological, and histopathological features that eventually led to the identification of epithelioid angiomyolipoma.

CONCLUSIONS

Epithelioid angiomyolipoma is easily misdiagnosed in clinical work. When dealing with these patients, it is necessary to make a comprehensive diagnosis based on clinical symptoms, imaging manifestations, and pathological characteristics.

摘要

背景

肾上皮样血管平滑肌脂肪瘤是经典血管平滑肌脂肪瘤的一种罕见且独特的亚型,其特征为上皮样细胞的存在。由于其在临床和影像学特征上与肾细胞癌和经典血管平滑肌脂肪瘤相似,因此常表现为非特异性症状,容易误诊。本病例报告的意义在于展示了诊断上皮样血管平滑肌脂肪瘤的挑战,并强调了准确区分肾细胞癌和经典血管平滑肌脂肪瘤的重要性。

病例介绍

一名 58 岁亚裔女性因突发左侧腰痛就诊,最初根据影像学检查诊断为恶性肾肿瘤。她接受了腹腔镜根治性肾切除术,术后组织病理学证实为上皮样血管平滑肌脂肪瘤。患者恢复良好,目前健康状况良好,定期随访。本病例强调了诊断挑战,重点介绍了最终确定上皮样血管平滑肌脂肪瘤的临床、影像学和组织病理学特征。

结论

上皮样血管平滑肌脂肪瘤在临床工作中容易误诊。在处理这些患者时,需要根据临床症状、影像学表现和病理特征进行综合诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5141/11391642/84f5186ec280/13256_2024_4743_Fig1_HTML.jpg

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