Renal Pelvis Leiomyoma- An Infrequent Clinical Case

Romano, Fernando Ugarte-Y; González-Serrano, Adolfo; Moreno-Aranda, Jorge

doi:10.7860/jcdr/2017/26174.9952

Cited by 1 publication

(1 citation statement)

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“…Although the majority of kidney leiomyomas in the literature are adults, they can also be detected in children. Symptoms of leiomyomas vary according to localization in the urinary system, whereas those originating from the kidney often do not cause symptoms and may radiologically mimic other malignant masses of the kidney (3,4).…”

Section: Introductionmentioning

confidence: 99%

Challenges in Differential Diagnosis: A Case Series of Four Adult Patients with Renal Leiomyoma

Mercimek¹,

Özden²,

Yakupoğlu³

2019

uob

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terms of clinical, radiological evaluation, surgical management, and histopathological and immunohistological assessment. Case Reports This study was conducted in accordance with the declaration of Helsinki. All patients read the patient information form and written informed consents were obtained. Case 1: A 45-year-old woman with a history of open uterine myomectomy five years ago presented with pain in the left lower quadrant for one week. Physical examination, urine and blood analyses were normal. Abdominal ultrasonography (US) revealed a 5 cm mass in the lower pole of the right pelvic ptotic kidney. Further imaging with computerized tomography (CT) was performed and revealed a completely exophytic, wellcircumscribed, homogeneously contrast enhancing, 6x5 cm renal mass (Figure 1A and Figure 2). Since renal cell carcinoma could not be ruled out, laparoscopic partial nephrectomy was carried out for the management of the renal mass. Postoperative course was uneventful and the patient was discharged on the 3 rd post-operative day. Pathological gross examination of the surgical specimen revealed a 7x5x4 cm fibrillary mass in the form of a benign smooth muscle tumor with a hard-rubbery Leiomyomas are rare, benign and solid tumors of the kidney. Although the developments in radiological imaging methods provide early detection of kidney tumors, it is difficult to differentiate leiomyomas radiologically from other malignant renal tumors. Moreover, the definitive diagnosis of leiomyomas can only be achieved by histopathological and also immunohistochemical evaluation after surgical intervention. Immunohistochemically, positive staining with smooth muscle actin and vimentin, whereas negative staining with cytokeratin, S100, Mart1 and HMB45 are the methods used in the differential diagnosis of leiomyomas. In this case series, after preoperative radiological evaluation, two female and two male patients between 45 and 89 years of age underwent laparoscopic treatment with the diagnosis of a malignant mass in the kidney. We aimed to illustrate the clinical, radiological and histopathological relationship of four adult patients who were managed by laparoscopic approach and diagnosed with renal leiomyoma. Renal leiomyomas should be kept in mind in patients with a renal mass before definitive treatment.

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Section: Introductionmentioning

confidence: 99%