Unusual Clinical Manifestations of Congenital Renal Arteriovenous Malformation

Abstract

Congenital renal arteriovenous malformation (ATM) is a rare clinical disease. Due to the recent availability of color-Doppler ultrasound and angiography, the successful detection rate of congenital renal ATM has increased. The treatments of choice range from transcatheter arterial embolization (TAE) to nephrectomy. However, the goal of treatment is to preserve a high degree of renal function. In this paper, we report on a case of congenital renal ATM presented with gross hematuria and right flank pain. Abdominal computed tomography revealed a huge cystic tumor mass over the right retroperitoneal space. Renal cell carcinoma was highly suspected. Following color-Doppler ultrasound and angiography, a right renal aneurysm was detected. Sever impairment of renal function and renal atrophy were noted as well. Finally, the patient received total nephrectomy. However, the histopathological analysis of the tumor found it to be a ruptured renal AVM. Neither hematuria nor flank pain were found during follow-up.