Muhammad Ramzan Chaudhry, Muhammad Atique, Fahim Anwar, Akbar Waheed, Muhammad Dilawar, Khalil Ullah.
Renal Angiomyolipoma.
Pak Armed Forces Med J Jan ;51(2):195-6.

CASE 1: A 56 years old female presented with pain the right lumber region of three-months duration. There was no urinary complaints or history of weight loss. Ultrasound and scan of the abdomen revealed a mass measuring 6 cms in size in the upper pole of right kidney. Right nephrectomy was done. The specimen revealed right kidney with a well-circumscribed mass measuring 6 cms towards the upper pole having firm consistency. The cut surface was gray white with yellow areas. The microscopic sections of the tumor comprised of spindle shaped smooth muscle cells arranged in fascicles and radial configuration with long axis perpendicular to blood vessels. There were few clusters of epitheloid cells most likely of smooth muscle origin as the tumor was mostly composed of that. There was very scanty fat component. Post operatively the patient had an uneventful recovery and was discharged on tenth postoperative day. Follow up of the patient for six-month did not reveal any recurrence/malignant transformation.

CASE 2: A 50 years old female presented with pain abdomen and pallor. The pain was later confined to left renal area. There was no sign of skin tumors, cerebral symptoms or any evidence of pigmentation. Laboratory investigations revealed Hemoglobin Percentage of 7.0 g/dl with ESR of 40 mm at the end of first hour. Ultrasound showed a large tumor in the upper pole of left kidney with haemorrhages inside the renal capsul and in the perinepheric area. Left radical nephrectomy was done. The specimen consisted of left kidney with perinepheric fat. A tumor was present at the upper pole measuring 7.0x5x2.0cms. The cut surface was yellow, only with haemorrhagic areas. Perinepheric tissue also had clotted blood and haemorrhages. The microscopic sections revealed left kidney with a tumor formed by mature adipose tissue. There were scattered smooth muscle fibers arranged in fascicles and radially arranged around the thick walled blood vessels. Areas of hemorrhages were also evident with many hemosidderin-laden macrophages. Postoperatively patient had an uneventful recovery and did not show any recurrence in other organs.

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