ANGIOMYOLIPOMA of KIDNEY and TUBEROUS SCLEROSIS
NGUYEN THIEN HUNG
MEDIC Medical Center
Ho Chi Minh City, Vietnam
Many red spots on the faces of the 2 male 10 year-old boys and an hypermelanic macula on right lower quadrant of the abdomen of a 15 year-old boy and many white spots at the right inguinal region of one of 2 boys. Ultrasound scanning detects a hyperechoic mass without rim sign on the kidneys, type angiomyolipoma (AML). Both of them have no history of hematuria or psychological disorders.
Discussion:
AML tumor of the kidney associates with tuberous sclerosis in 50% of cases (2). In tuberous sclerotic patients, AML tumors are always small in size and in both 2 kidneys. In patients without tuberous sclerosis, AML tumors are usually single and occur in female more than 4 times in comparison with male patient. Ultrasound findings of AML tumors are echogenic mass, rich echo or isoechoic with fatty tissue of renal sinus. But ultrasound cannot definitively diagnose because some renal cellular carcinomas (RCC) are echogenic. CT scan helps to confirme fatty tissue inside the tumor. Because RCC rarely has fatty tissue that a fat attenuation renal tumor is usually diagnosed AML.
Conclusions:
1- Hyperechoic renal tumors are AML or RCC, AML with posterior enhancement and RCC with rim sign in ultrasound findings. Different diagnosing by CT scan should be used because ultrasound cannot give exactly diagnosis lonely.
2- AML usually associates with tuberous sclerosis (50%).
References:
1.Sim J S et al: Small echogenic lesions of the renal cortex, J Ultrasound Med 1999; 18:261-264.
2.Specht, NT: Practical Guide to Diagnostic Imaging, pp.524-525, Mosby, 1998.
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Fig1: 2 tuberous sclerotic 10 year-old patients
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right inguinal region (adenoma sebaceum) |
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Fig2:hypermelanic macula in the RLQ of abdominal wall of male 15 year-old patient. |
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Fig 3: Left AML (10 yo boy) and Right and left AML and AML of 2 kidneys (15 yo boy).
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