Correlation of Selective Angiography and Pathology in Cavernous Hemangioma of the Kidney

Abstract

Angiographic and pathologic findings are presented and correlated in a case of renal cavernous hemangioma, and considered in relation to 3 other cases published previously. A normal angiogram does not exclude a cavernous hemangioma. Those tumors with a large arterial component may be demonstrated in the arterial phase of the angiogram. A discrete tumor may show an area of hypovascularity by displacing normal renal tissue but a diffuse cavernous hemangioma is likely to yield a normal angiogram.

Radiologic Findings of Renal Hemangioma: Report of Three Cases

“…Generally, surgery is considered when the tumor causes symptoms such as life-threatening hemorrhage, or when it is difficult to distinguish the lesion from a disease such as carcinoma which requires nephrectomy. Hemi- or total nephrectomy is the procedure of choice (1, 4, 7), and radiation therapy and transarterial embolization are sometimes employed (1, 4, 6, 11). …”

Benign lateralizing haematuria: the impact of upper tract endoscopy

“…Almost all cases diagnosed preoperatively have been detected by selective angiography [40–47]. As well as size and the presence of thrombosed vessels, the diagnosis of haemangiomas by angiography depends on the nature of their vascular structure [40,41,48] with diffuse cavernous lesions likely to produce a normal angiogram [48]. Experience with ultrasonography, CT and MRI in the diagnosis of renal haemangiomas is limited [49,50].…”

Sonography, CT, and MRI of Giant Cavernous Hemangioma of the Kidney: Correlation with Pathologic Findings

“…Descriptions of renal cavernous hemangiomas on angiography have included a normal appearance [3], a hypovascular mass producing varying degrees of caliceal deformity [4], and a hypervascular mass with rapid arteriovenous shunting [5]. Three case reports all described the sonographic appearance of renal cavernous hemangioma as a hyperechoic lesion [2,6,7], in contrast to the hypoechoic lesion we found.…”

“…It seems likely that any of the three angiographic patterns of renal cavernous hemangiomas described in the literature [3][4][5] could also appear on CT angiography of this lesion. To our knowledge, no case report in the English-language literature describes the MRI appearance of a renal cavernous hemangioma.…”