Renal lymphangiectasia (RLM) is a rare condition characterized by dilatation of perirenal, parapelvic or intrarenal lymphatics. We report an unusual case of bilateral RLM in a 20-year-old Malay male who presented with 1 month duration of bilateral flank pain. Bedside ultrasound showed bilateral perinephric collections, which were further confirmed on computer tomography intravenous pyelogram (CT IVP). Other causes of perinephric collections were ruled out based on laboratory and radiological findings, and he was managed conservatively as for RLM with surveillance ultrasound kidneys at 3 to 6 monthly intervals.
Retroperitoneal benign lipoid lesions are extremely rare, representing about 2.9% of all primary retroperitoneal tumors. Despite being of benign origin, they can have severe complications. We report a case of an elderly Chinese male presenting with urinary obstruction and lower limb deep vein thrombosis, with computer tomography findings of an extending pre-sacral retroperitoneal lesion. Histology and fluorescence in situ hybridization investigations confirmed that the lesion was of benign lipoid origin. Patient was offered surgical intervention which he declined in view of age.
Angiomyolipoma (AML) of the kidney is a benign hamartomatous neoplasm which is usually asymptomatic and picked up incidentally on radiological imaging. AMLs that present symptomatically are typically those of large sizes exceeding 4cm with complications of rupture and retroperitoneal bleed. The classical triad in symptomatic cases includes flank pain, flank mass and gross haematuria. In cases of severe hemorrhage, patients may even turn hypotensive. AMLs rarely present as fever or urinary tract infection. This report presents a case of a middle-aged lady who presented with fever and lower urinary tract symptoms, and urinary studies performed were suggestive of a urinary tract infection. Radiological investigations revealed a right sided renal AML. This report discusses how renal AMLs can present atypically and includes a review of literature.
Angiomyolipoma (AML) of the kidney is a benign hamartomatous neoplasm which is usually asymptomatic and picked up incidentally on radiological imaging. AMLs that present symptomatically are typically those of large sizes exceeding 4cm with complications of rupture and retroperitoneal bleed. The classical triad in symptomatic cases includes flank pain, flank mass and gross hematuria. In cases of severe hemorrhage, patients may even turn hypotensive. AMLs rarely present as fever or urinary tract infection. This report presents a case of a middle-aged lady who presented with fever and symptoms of urinary tract infection, with urine tests suggestive of a urinary tract infection. Radiological investigations revealed a right-sided renal AML. This report discusses how renal AMLs can present atypically and includes a review of literature.
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