Dramatic Reduction Of Symptomatic Renal Angiomyolipoma With Pseudoaneurysm By Selective Arterial Embolization: A Case Presentation

Purpose: Angiomyolipomas are usually diagnosed incidentally and are usually asymptomatic. Dysmorphic blood vessels in angiomyolipomas usually do not contain an internal elastic lamina, so bleeding risks are high. Particularly, lesions larger than 4 cm have a tendency to become symptomatic and can present with life-threatening retroperitoneal or urinary bleeding. Although intrarenal or perinephric bleeding is the usual complication of angiomyolipomas, a pseudoaneurysm appears unusual. In this case, we aimed to present a patient with pseudoaneurysm, an unusual complication of angiomyolipoma. Case presentation: In this article, a patient who presented with complaints of left flank pain and hematuria and who underwent selective arterial embolization due to pseudoaneurysmatic angiomyolipoma in the left kidney is presented. The patient's angiography showed a large hypervascular mass filling the upper and middle segments of the left kidney. A pseudoaneurysmal filling originating from a subsegmental branch was observed in the mass. The patient underwent selective embolization. After 5 years of follow-up, the mass was observed to shrink. Conclusions: Angiomyolipomas are benign tumors, but especially symptomatic masses larger than 4 cm and especially masses with aneurysms larger than 5 mm can cause life-threatening retroperitoneal hemorrhages. Coexistence of angiomyolipomas with pseudoaneurysm is rare, especially. Safe, effective and minimally invasive selective arterial embolization can be safely performed to prevent massive bleeding and rupture.