A case of postpartum spontaneous rupture of an angiomyolipoma

A case of postpartum spontaneous rupture of angiomyolipoma in a 27-year-old woman with the chief complaints of right flank pain and fever was reported. Physical examinations revealed an infant-head sized, hard elastic mass with a smooth surface in the right flank. Laboratory studies showed a decrease of Hb to 9.0 g/dl and Ht to 26.5%, and elevated LDH (2914 IU/l). Angiomyolipoma was suspected with ultrasonography, CT scan and angiography. Transperitoneal right nephrectomy was performed. The right kidney and tumor weighed 1,870 g. Pathological diagnosis also confirmed angiomyolipoma of the kidney. Discussion of the case and a brief review of the literature on spontaneous rupture of angiomyolipoma in the intra- and postpartum are made.     

A case of testicular angiomyolipoma

Abstract:   The majority of testicular tumors are germ cell tumors, which are the most prevalent solid malignancies in young adult males. Non-germ cell tumors of the testis are rare. Here, we report a case of testicular angiomyolipoma (AML). A 22-year-old male underwent left orchiectomy under a diagnosis of testicular tumor. Pathological analysis demonstrated that it was composed of adipose tissue and vasculature with foci of myomatous component. The tumor demonstrated neither cytological atypia nor widespread mitotic activity. In addition, the tumor cells showed intense expression of CD34 and smooth muscle actin, whereas HMB-45 was entirely negative. Although the true cellular origin and its clinical implications remain unknown, pathological and immunohistochemical studies strongly indicated benign testicular AML with a non-germ cell origin. To our knowledge, this is only the second case of a primary testicular AML in the published reports and the detailed pathological findings are first described in this report.     

A case of angiomyolipoma originating from polycystic kidney with horseshoe kidney

A case of renal angiomyolipoma originating from polycystic kidney with horseshoe kidney is reported. A 32-year-old woman visited our hospital with the complaint of proteinuria. with computerized tomographic scan and further examinations the patient was diagnosed as having renal angiomyolipoma with tuberous sclerosis. The tumor originated from a polycystic horseshoe kidney. Three weeks later, she complained of right flank pain and was diagnosed with spontaneous rupture of the angiomyolipoma. Right heminephrectomy was performed and histological examination confirmed the preoperative diagnosis. Some discussion is made on the characteristics and treatment of renal angiomyolipoma, and the statistics on renal diseases with tuberous sclerosis in Japan are presented.     

A case of chondroblastoma arising from the temporal bone

A 33-year-old male sustained hearing disturbance in the left ear that exacerbated over a period of three years. The patient was referred to the department of otorhynolaryngology for severe stenosis of the left external auditory canal, where neuroimaging study revealed a huge tumor in the left temporal fossa. On first examination, he showed a significant facial nerve paresis and conductive hearing loss. CT scans identified a 4.5×4.5×4.5 cm mass with intralesional calcification and extensive bony destruction in the squamous and petrous parts of the temporal bone and middle cranial fossa floor. MR imaging demonstrated the tumor of heterogenous intensity on T1-and hypointensity on T2-weighted image. The patient underwent gross total resection of the lesion via frontotemporal craniotomy. The bony and ligamentous structures around the temporomandibular joint appeared mostly intact and did not need any reconstructive surgery after tumor resection. Postoperatively the patient's facial nerve paresis showed a transient exacerbation which resolved gradually, while hearing disturbance did not improve. Histological findings of the tumor were consistent with the qualities of chondroblastoma. We should assume chondroblastoma as differential diagnosis when we encounter a temporal bone tumor that is curable by surgical resection.     

Exophytic renal angiomyolipoma. A case report

A case of a large exophytic renal angiomyolipoma is presented. Despite the features on excretory urography suggestive of an extrarenal mass, computed tomography provided information concerning the origin and pathological nature of the lesion.     

A case of angiomyolipoma of the renal sinus

The case of a 63-year-old woman with a relatively rapidly growing angiomyolipoma (AML) originating from the right renal sinus is presented. The tumor had enlarged to more than fivefold in volume (7.4 × 6.7 × 10.1 cm) in the 7 years following its detection (5.6 × 3.4 × 4.6 cm) and had significantly pushed aside the duodenum and the inferior vena cava. The tumor was surgically resected together with the right kidney, and pathological examination revealed AML originating from the renal sinus. An AML involving or originating from the renal sinus is exceedingly rare; only 14 cases have been reported. Rapidly growing AMLs of the renal sinus are difficult to differentiate from liposarcoma because of similar findings in imaging studies. It should be noted that AML of the renal sinus can be a differential diagnosis of retroperitoneal fatty mass. Furthermore, an enlarged AML in the renal sinus may push aside other organs, such as the ileum, pancreas, and major vessels. Clinicians should determine whether these patients should be placed under active surveillance or be treated with invasive measures, such as radical nephrectomy.     

A case of renal angiomyolipoma treated by partial nephrectomy--the management of renal angiomyolipoma from the conservative point of view

A 25-year-old female was admitted for further investigation of the right renal mass, which was noted during evaluation for hepatitis. She had no personal or family history of stigmas of tuberous sclerosis. On physical examination, a movable hard smooth mass of fist size was palpable in the right abdomen. Drip infusion pyelography revealed an elevation of right kidney. Ultrasonography revealed that the abdominal mass had a high amplitude echo area. On CT the mass was heterogeneous with irregular margin and had regions of low attenuation value, suspicious of a tumor with high fat content. An angiogram of the right renal artery revealed a hypervascular tumor showing multiple saccular aneurysms, and absence of arteriovenous shunting. Based on the aforementioned findings, the mass was diagnosed as renal angiomyolipoma. Partial right nephrectomy was performed through an extraperitoneal approach. Pathological diagnosis was a renal angiomyolipoma. Convalescence was uneventful, and the remaining parenchyma of right kidney was working well on drip infusion pyelography three months after operation. The management of renal angiomyolipoma from the conservative point of view is also discussed.     

A case of Hodgkin's disease arising from an intraglandular lymph node in the parotid gland

Malignant lymphoma of the parotid gland region, especially Hodgkin's disease of the gland, is an extremely rare disorder. We have recently experienced a case initially suspected of being pleomorphic adenoma and later, on postoperative histopathological examination, diagnosed as Hodgkin's disease. The present report describes this case of Hodgkin's disease arising from an intraglandular lymph node in the parotid gland.     

A case of angiomyolipoma in a horseshoe kidney

The patient was 52 years old. She had undergone a breast cancer operation 4 years before this visit. On computed tomography (CT), a left renal tumor in a horseshoe kidney was incidentally pointed out. CT scan showed a 1.8-cm enhanced tumor in the upper pole of the left kidney. It was hyperechoic on ultrasonography. Since renal cell carcinoma could not be excluded preoperatively, left partial nephrectomy was performed. Pathological diagnosis was a renal angiomyolipoma. The incidence of horseshoe kidney is 1 in 400. The occurrence of hydronephrosis, infection and calculous disease is not uncommon. However, a case of angiomyolipoma simultaneously with a horseshoe kidney is very rare, this being the 7th case in the literature.     

A case of renal angiomyolipoma with tumor thrombus

A 42-year-old woman presented with left renal tumor. Computed tomography showed a left renal tumor (6 cm in diameter) and a tumor thrombus at the left renal vein, which had equal density to fat tissue. She was diagnosed with malignant tumor, and underwent radical left nephrectomy and resection of thrombus. Pathological diagnosis was angiomyolipoma with no findings of malignancy. No signs of recurrence or metastasis have been observed for 8 months after the operation.     

A case of renal angiomyolipoma with bone formation

A case of renal angiomyolipoma with bone formation is reported. A 61-year-old woman was admitted to our hospital with one month history of fever. About 15 cm in diameter mass was palpated in her right lower abdomen. Plain abdominal roentgenography, ultrasonography and computed tomography showed marked calcification in the cephalic portion of the right kidney, tumors surrounding right kidney and another tumor in the right lower abdomen. All these tumors and the kidney constituted a big mass continuously, and no fatty component was demonstrated. Total excision of the mass including the kidney was performed. The mass was 30 X 24 X 10 cm in size and 3,240 g in weight. Histologically, the tumor was compatible to renal angiomyolipoma. But, radiopaque shadows which looked like calcification were disclosed to be bones, and fatty tissues were not seen so much. Therefore, the name "benign mesenchymoma" was thought to be more acceptable than angiomyolipoma in this case. Preoperative diagnosis of renal angiomyolipoma is the demonstration of fatty densities in the tumor, and the characteristic extrarenal development should also be taken into consideration. Furthermore, the bone formation of angiomyolipoma, which is very rare might be an important finding to angiomyolipoma.     

A case of chondrosarcoma arising from the left first rib

A 46-year-old female was admitted to our hospital because of a left supraclavicular tumor. The chest CT scan and MR imaging revealed that the tumor arose from the left first rib and developed into the supraclavicular region. In this case, we tried to resect the tumor using the so-called "trap-door" thoracotomy. Although removal of subclavian vessels and brachial plexus from the tumor was easily performed, we could not enough treat the vertebral side of the first rib through this thoracotomy without the T1 nerves injury. In cases of superior sulcus tumors developing into the posterior chest wall, a posterior incision combined with an anterior one will be useful to remove these tumors safely.     

Calcification in an angiomyolipoma: a case report.

A patient with tuberous sclerosis and angiomyolipoma of both kidneys is described in whom both tumors demonstrated associated calcification. This finding has not been previously stressed in the literature and is important in that ignorance of its occurence in this tumor might result in an error of diagnosis and nephrectomy in a patient who can ill-afford the loss of renal parenchyma.     

A case of retroperitoneal liposarcoma arising from the renal capsule

We treated a case of retroperitoneal liposarcoma arising from the renal capsule by operation and adjuvant radiation. A 61-year-old woman was referred to our department for treatment of a right renal tumor revealed by computed tomography (CT). CT, magnetic resonance imaging and angiography demonstrated a large renal tumor with fat tissue, fed from the renal capsular artery. Right radical nephrectomy was performed on February 4, 2003. The tumor was diagnosed histopathologically as well differentiated liposarcoma arising from the renal capsule. The surgical margin was positive. Therefore, the patient was given 50 Gy of radiation postoperatively. There have been only 18 reports of liposarcoma arising from the renal capsule in Japan.