Bilateral renal angiomyolipoma where one side exploded naturally: A case report

A 78-year-old woman presented with sudden left lower abdominal pain. She had been initially diagnosed as acute abdomen at a previous hospital. Conservative treatment was given, but her condition did not improve. Computed tomography (CT) examination was performed eight hours later, and CT showed a huge tumor with hemorrhage in the inferior pole of the left kidney. She was transported to our hospital for the purpose treatment. CT examination showed bilateral renal tumors and a fat-level low-density area. The tumors were diagnosed as bilateral renal angiomyolipoma (AML) and the patient was thought to be in a state of shock brought about by spontaneous rupture of the left AML. We judged that the patient was not able to recover with conservative treatment only, and so left nephrectomy was carried out as an emergency procedure. Because her overall status was stable, without any complications from the operation, the patient was discharged. Six months later, the patient underwent, partial nephrectomy for the right AML of more than 5 cm in size. The tumors were diagnosed pathologically as bilateral renal AML.