Adnyana Anak Agung Ngurah Krisnanta, Suarsana I Wayan, Putra Ida Bagus Oka Widya
Wangaya General Hospital, Denpasar, Bali, Indonesia.
Faculty of Medicine, Mahasaraswati Denpasar University, Wangaya General Hospital, Denpasar, Bali, Indonesia.
Int J Surg Case Rep. 2024 Nov;124:110429. doi: 10.1016/j.ijscr.2024.110429. Epub 2024 Oct 10.
Renal leiomyoma is a rare renal tumor that originates from smooth muscle. Among all existing benign renal tumors, leiomyoma is one of the least common benign renal tumors.
We report of a case report of a 43-year-old male complaints of palpable mass on the upper left abdomen, abdominal discomfort and hematuria. Contrast-enhanced CT scan revealed a solid heterogenous mass on the left kidney, adherent to the left abdominal wall and pushed the spleen cranially. Patient underwent radical nephrectomy and histopathology results revealed leiomyoma. Two weeks after surgery, the patient was asymptomatic.
Imaging of renal leiomyoma may provide a clue with a general finding of a well-defined tumor margin and no local invasion. In our case preoperative CT findings made the initial diagnosis inconclusive since it showed the renal mass was adherent to the abdominal wall. Definitive diagnosis was only possible through histopathologic examination.
Radical nephrectomy remains as the mainstay of treatment in inconclusive preoperative diagnosis.
肾平滑肌瘤是一种罕见的起源于平滑肌的肾肿瘤。在所有现有的良性肾肿瘤中，平滑肌瘤是最不常见的良性肾肿瘤之一。
我们报告一例43岁男性病例，患者主诉左上腹可触及肿块、腹部不适及血尿。增强CT扫描显示左肾有一实性不均匀肿块，与左腹壁粘连并将脾脏向上推移。患者接受了根治性肾切除术，组织病理学结果显示为平滑肌瘤。术后两周，患者无症状。
肾平滑肌瘤的影像学表现可能提示肿瘤边界清晰且无局部浸润的一般特征。在我们的病例中，术前CT表现使初步诊断不明确，因为它显示肾肿块与腹壁粘连。只有通过组织病理学检查才能做出明确诊断。
在术前诊断不明确的情况下，根治性肾切除术仍是主要的治疗方法。
