J Korean Soc Radiol.  2014 Oct;71(4):186-190. 10.3348/jksr.2014.71.4.186.

Concurrent Renal Angiomyolipoma and Renal Cell Carcinoma: Report of Two Cases

• Kang KW
• Sung DJ
• Park BJ
• Kim MJ
• Han NY
• Cho SB
• Lee JH

• KMID: 2098004
• DOI: http://doi.org/10.3348/jksr.2014.71.4.186

Abstract

Concurrent renal cell carcinoma (RCC) and angiomyolipoma (AML) is a very rare condition, especially in patients without underlying tuberous sclerosis. We present three patients with concurrent RCC and AML in the ipsilateral kidney. Concurrent RCC is difficult to differentiate radiologically from a non-fatty component of an AML because they share several imaging findings. However, several noticeable radiologic features are helpful in the diagnosis of suspected cases. This report of two cases highlights the radiologic features that distinguish RCC from non-fatty components of AML.

MeSH Terms

Angiomyolipoma*
Carcinoma, Renal Cell*
Diagnosis
Humans
Kidney
Magnetic Resonance Imaging
Tuberous Sclerosis

Figure

• 

  Fig. 1 Initial axial CT images of a 65-year-old female patient reveal a 20.0 × 15.8 × 10.1 cm lobulated contoured fatty mass (arrows) in the right kidney and hyperdense fluid collection (arrowheads) in the right perinephric space. Additionally, a 1.9-cm well-defined mass (curved arrow) adjacent to the inferior aspect of the fatty mass is identified. The enhancing mass shows contrast enhancement on the corticomedullary phase (A) and delayed wash-out on the excretory phase (B). Follow-up axial CT images on the corticomedullary phase after 55 months (C) demonstrates gradual growth of the enhancing mass (arrow) throughout the entire follow-up period. Multi Shot Turbo Spin Echo T2-weighted (repetition time/echo time = 1641/70 ms) spectral presaturation inversion recovery fat-suppression MRI (D) shows hyperintensity of the enhancing mass. Photomicrograph of the mass (E) shows a typical alveolar architectural pattern separated by thin-walled blood vessels, suggesting clear cell type renal cell carcinoma. The tumor cells have distinct cell borders and optically clear or eosinophilic granular cytoplasm (H&E, × 400).

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  Fig. 2 A coronal CT image of a 45-year-old male patient (A) reveals a 3.7-cm well-defined mass (arrow) and a 4.0-cm well-defined mass (curved arrow) in the right kidney upper pole and lower pole, respectively. The upper pole mass (arrow) shows strong heterogeneous enhancement on the corticomedullary phase (B).

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