Abstract
Renal angiomyolipoma is a benign tumor, composed of adipocytes, smooth muscle cells and blood vessels. The association with pregnancy is rare and related with an increased risk of complications, including rupture with massive retroperitoneal hemorrhage. The follow-up is controversial because of the lack of known cases, but the priorities are: timely diagnosis in urgent cases and a conservative treatment when possible. The mode of delivery is not consensual and should be individualized to each case. We report a case of a pregnant woman with 18 weeks of gestation admitted in the emergency room with an acute right low back pain with no other symptoms. The diagnosis of rupture of renal angiomyolipoma was established by ultrasound and, due to hemodynamically stability, conservative treatment with imaging and clinical monitoring was chosen. At 35 weeks of gestation, it was performed elective cesarean section without complications for both mother and fetus.
Highlights
The angiomyolipoma (AML) is often a benign tumor consisting of three types of histologic features: adipocytes, smooth muscle cells and blood vessels with thickened wall[1,2,3]
As in most cases there are no symptomatic manifestations[1,2], the AMLs are often diagnosed as incidentalomas[1,4], they may be related to severe symptoms[9,10,11,12]
About 20% of the cases are associated with tuberous sclerosis, which is an autosomal dominant disease, rare, characterized by the growth of benign tumors in multiple organs[16,17,18]
Summary
The angiomyolipoma (AML) is often a benign tumor consisting of three types of histologic features: adipocytes, smooth muscle cells and blood vessels with thickened wall[1,2,3]. There are two known types of AML: the isolated angiomyolipoma, which represents 80% of cases, and the one associated with tuberous sclerosis (TS)[1,7,8]. These masses are usually solitary, large and asymptomatic, and the mean age of diagnosis is 43 years[1,4,7].
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