BLEEDING TUMOR OF KIDNEY (ANGIOMYOLIPOMA)

Most of us ignore abdominal pain till it gets severe enough to ssek medical help. After initial investigations, most of the times, the cause is benign, but rarely it could be an underlying malignancy or something ominous. 

A 50 y man presented with rt flank pain, vague, dull aching for last 3 months. It aggravated suddenly the last 2 days. On evaluation there was an Angiomyolipoma, involving the Rt kidney which has bled. after initial stabilisation, The tumor was angioembolised and later it was surgically removed.

Angiomyolipomas are the most common benign tumour of the kidney and are composed of blood vessels, smooth muscle cells and fat cells. Angiomyolipomas are strongly associated with the genetic disease tuberous sclerosis, in which most individuals will have several angiomyolipomas affecting both kidneys. They are also commonly found in women with the rare lung disease lymphangioleiomyomatosis. Angiomyolipomas are less commonly found in the liver and rarely in other organs. Whether associated with these diseases or sporadic, angiomyolipomas are caused by mutations in either the TSC1 or TSC2 genes, which govern cell growth and proliferation. Although regarded as benign, angiomyolipomas may grow such that kidney function is impaired or the blood vessels may dilate and burst leading to haemorrhage. Large angiomyolipoma can be treated with embolisation. Drug therapy for angiomyolipoma is at the research stage.