Abstract
Introduction: The angiomyolipoma (AML) is constituted by adipose tissue, blood vessels and smooth muscle fiber; follows a benign clinical course, with slow growth and absence of metastasis, occurring in tuberous sclerosis or sporadically. Objective: We intend to describe the clinical, radiological and histological aspects of this tumor. Case report: A-64-year-old woman presented with abdominal pain and dyspepsia. Tomography showed hepatic, renal and mesenteric nodules. Histological evaluation of mesenteric lymph node revealed perivascular epithelioid differentiation neoplasia, compatible with AML/perivascular epithelioid cell tumor (PEComa), positive for anti-S100, anti-human melanoma black-45 (HMB-45) and anti-smooth muscle actin. Conclusion: We described a rare AML with renal, hepatic and lymph node involvement, representing a multicenter version instead of metastasis.
Highlights
The angiomyolipoma (AML) is a benign tumor composed of three different kinds of tissue: adipose tissue, blood vessels and smooth muscle fibers
The suggestion of AML diagnosis may be offered by a combination of imaging exams, such as ultrasonography (USG), computed tomography (CT) and magnetic resonance (MR), which evidence the fat tissue present in the mass; but renal cell carcinoma is an important differential diagnosis
We describe a rare case of AML with simultaneous renal, hepatic and lymph node involvement, which may be confounded with metastatic tumors
Summary
The angiomyolipoma (AML) is a benign tumor composed of three different kinds of tissue: adipose tissue, blood vessels and smooth muscle fibers. It represents 1%-3% of all renal tumors, and may occur as part of the tuberous sclerosis complex (TSC), or sporadically. AML is mostly asymptomatic, and accidentally diagnosed, but it may present with abdominal pain, palpable abdominal mass, lumbar pain, and severe hematuria, besides other consequences of intratumoral hemorrhage[3, 4]. The suggestion of AML diagnosis may be offered by a combination of imaging exams, such as ultrasonography (USG), computed tomography (CT) and magnetic resonance (MR), which evidence the fat tissue present in the mass; but renal cell carcinoma is an important differential diagnosis. Diagnosis is confirmed by biopsy and histopathological analysis with immunohistochemistry[1, 5]
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