A massive renal epithelioid angiomyolipoma with multiple metastatic lymph nodes

Abstract A 47-year-old man presented with dull pain in the left upper abdomen for 1 year. Computed tomograph (CT) examination revealed a very large heterogeneously enhancing mass in the left kidney, measuring up to 28 cm. The mass was accompanied by several enlarged lymph nodes in the peri-aortic re...

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Bibliographic Details
Published in:Clinical imaging 2011-07, Vol.35 (4), p.320-323
Main Authors: Cui, Lei, Hu, Xiao-Yun, Gong, Shen-Chu, Fang, Xiang-Ming, Lerner, Alexander, Zhou, Zhi-Yi
Format: Article
Language:English
Subjects:
Angiomyolipoma - diagnostic imaging
Angiomyolipoma - surgery
Biomarkers, Tumor - analysis
Diagnosis, Differential
Epithelioid angiomyolipoma
Humans
Immunohistochemistry
Kidney neoplasms
Kidney Neoplasms - diagnostic imaging
Kidney Neoplasms - surgery
Lymphatic Metastasis
Male
Melanoma-Specific Antigens - analysis
Middle Aged
Nephrectomy
Pathology
Perivascular Epithelioid Cell Neoplasms - diagnostic imaging
Perivascular Epithelioid Cell Neoplasms - surgery
Radiology
Tomography, X-Ray Computed
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Summary:Abstract A 47-year-old man presented with dull pain in the left upper abdomen for 1 year. Computed tomograph (CT) examination revealed a very large heterogeneously enhancing mass in the left kidney, measuring up to 28 cm. The mass was accompanied by several enlarged lymph nodes in the peri-aortic region. Radical nephrectomy was performed and pathologic evaluation revealed sheets of epithelioid cells and piecemeal necrosis consistent with malignant epithelioid angiomyolipoma (EAML) with regional lymph node metastases. The tumor cells were strongly positive for human melanosome-associated protein (HMB-45) on immunohistochemical staining. There was neither metastasis nor recurrence 2 years postoperatively. EAML is a rare tumor of mesenchymal tissue with potential for aggressive behavior. If this neoplasm is suspected based on CT features, EAML should be confirmed by pathology and immunohistochemistry.
ISSN:0899-7071
1873-4499
DOI:10.1016/j.clinimag.2010.08.017