Nephron sparing surgery for giant renal angiomyolipoma; a viable option?

Abstract

Angiomyolipomas (AML) are most common benign tumors of the Kidney. It may be an incidental diagnosis or in symptomatic patients it may cause flank pain,hematuria or renal mass. Also, sometimes renal AML may present initially as spontaneous retroperitoneal hemorrhage secondary to rupture (Wunderlich syndrome). AML >10 cm in size is known as giant AML and the data available on this entity is sparse. Herein, we report a case of a 28-year-old homemaker who had left flank pain for 3 months, on evaluation elsewhere, Ultrasonography, and Contrast Computed Tomography Scan - Kidney Ureter Bladder showed a left giant renal AML. This patient came to our centre for further management. Subsequently, this patient underwent left open Partial Nephrectomy; specimen was 21.5 cm x 16 cm x 14 cm in size and weighed 1330 g. Histopathological analysis showed AML. It is important to contemplate a primary nephron sparing approach even in a case of giant renal AML, as it may turn out to be a correct choice with a positive outcome.