Grossly, it had been well- circumscribed and with a glistening yellow (fatty) appearance

Grossly, it had been well- circumscribed and with a glistening yellow (fatty) appearance. as sporadic AML ever reported in the literature. Keywords:Angiomyolipoma, giant kidney tumor, heaviest renal angiomyolipoma, sporadic tuberous sclerosis == INTRODUCTION == Renal angiomyolipoma (AML) is an infrequent tumor that, in most cases, follows a benign course and has clearly defined radiological and histological characteristics.[1] We present a case of giant renal AML, which is the Rabbit Polyclonal to BMP8B heaviest ever reported, encountered in a tertiary care hospital in India. == RADIOLOGIC FEATURES == A 49-year-old lady, a native of Afghanistan, presented with a 3-12 months history of continuously increasing abdominal girth and bloating sensation in the stomach. She also experienced intermittent dull ache in the left flank. She underwent investigation Myelin Basic Protein (68-82), guinea pig in another institute and was found to have a huge abdominal mass. Review of contrast enhanced computed tomography (CECT) scans of stomach revealed a large excess fat containing tumor measuring 40 cm 24 cm 10 cm (<20 Hounsfield Models), replacing the left Myelin Basic Protein (68-82), guinea pig kidney and displacing the rest of the abdominal contents toward the other side of the midline [Physique 1]. There was absence of enhancement, inhomogeneity, necrosis, or calcification ruling out the possibility of malignancy. A provisional diagnosis of benign renal neoplasm, possibly AML causing pressure effects was made. Hence, CECT scan of the head was carried out, which excluded any lesion suggestive of tuberous sclerosis (TS) [Physique 2] and decision of to perform nephrectomy was taken. == Physique 1. == 49-year-old lady with complaints of bloating sensation in the stomach and a continuously increasing abdominal girth, which was subsequently diagnosed as angiomyolipoma of left kidney. Contrast enhanced computed tomography scan axial section film of stomach reveals a lipomatous neoplasm 40 cm 24 cm 10 cm in dimensions (HU < 20 HU) replacing the entire left kidney, while displacing the rest of the abdominal contents (arrows) toward the other side of the midline. == Physique 2. == 49-year-old lady with complaints of bloating sensation in the stomach and a continuously increasing abdominal girth, which was subsequently diagnosed as Myelin Basic Protein (68-82), guinea pig angiomyolipoma of left kidney. Contrast enhanced computed tomography scan axial section films of the head reveals no lesion suggestive of tuberous sclerosis. == PATHOLOGIC FEATURES == Under intubated general anaesthesia, an abdominal midline incision was made extending from xiphisternum to just above pubic symphysis. The left kidney was seen to be completely replaced by a excess fat made up of tumor. Simple nephrectomy was performed with intact tumor retrieval and minimal blood loss, without necessitating any blood transfusion. The recovered surgical specimen measured 39 cm 25 cm 9 cm and weighed 7500 g with compressed renal hilar vessels and ureter [Physique 3]. Grossly, it Myelin Basic Protein (68-82), guinea pig was well- circumscribed and with a glistening yellow (fatty) appearance. Histopathological examination of the specimen revealed majority of the cells were mature adipocytes associated with thick-walled blood vessels and a few epithelioid stromal cells. There was a pattern with common excess fat and perivascular epithelioid cells arranged around a blood vessel, suggesting it to be AML [Physique 4]. Immuno-histochemical staining of the tissue by beta-hydroxy beta-methylbutyric acid-45 (HMB-45) (a melanosome-associated protein) indicated the presence of epithelioid component [Physique 5]. == Physique 3. == 49-year-old lady with complaints of bloating sensation in the stomach and a continuously increasing abdominal girth which was subsequently diagnosed as angiomyolipoma (AML) of left kidney. Excised specimen shows a giant AML 39 cm 25 cm 9 cm in dimensions and weighing 7500 g, replacing the whole kidney. Renal hilar vessels and ureter are compressed, and emerging out of the mass. == Physique 4. == 49-year-old lady with complaints of bloating sensation in the stomach and a continuously increasing abdominal girth, which was subsequently diagnosed as angiomyolipoma of left kidney. Histopathology slide of the excised mass shows admixture of tortuous thick-walled blood vessels (arrows), linens Myelin Basic Protein (68-82), guinea pig of mature adipose tissue (F) and bundles of easy muscle mass fibres (M) (Stain used hematoxylin and eosin, 100). == Physique 5. == 49-year-old lady with complaints of bloating sensation in the stomach and a continuously.