VCOM Louisiana Research Day Program Book 2024

Case Studies

Madison Cox, OMS-III; James Smith, MD Monroe, LA 52 RENAL ANGIOMYOLIPOMA: A CASE REPORT

Background: An angiomyolipoma (AML) is a rare, often asymptomatic, renal tumor composed of dystrophic blood vessels, smooth muscle, and mature adipose tissue. The pathophysiology of sporadic AMLs—although commonly misunderstood—is widely thought to be due to a spontaneous genetic mutation. Despite the low prevalence rate of renal AMLs, the potential for severe complications, such as spontaneous retroperitoneal hemorrhage, poses a life-threatening clinical risk. While a majority of cases are found incidentally on radiological imaging, symptomatic presentations may occur. For example, a symptomatic presentation occurred in the case of a 46- year-old African American female patient with a spontaneous left retroperitoneal bleed from a benign renal angiomyolipoma. The patient, with a medical history of hypertension and diabetes mellitus, presented with left upper quadrant abdominal pain, nausea, and vomiting. Advanced imaging and laboratory findings revealed a large mixed density retroperitoneal mass with evidence of vast hemorrhage. The patient’s deteriorating condition, marked by progressive abdominal distension, necessitated prompt surgical intervention. A total left nephrectomy was performed. This case emphasizes the

significance of methodical diagnostic imaging and monitoring in managing patients with suspected renal AMLs and serves as an addition to the literature in clinical presentation and laboratory findings to aid syndrome detection and treatment. Conclusions: While renal angiomyolipomas are often benign and asymptomatic, they can result in serious complications such as spontaneous retroperitoneal hemorrhage as seen in this case. Prompt diagnosis and responsive management strategies are crucial to ensure optimal patient outcomes.

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