A case of acute bleeding from a small, asymptomatic renal angiomyolipoma (AML) during pneumoperitoneum induction for a rectal tumor resulting in acute hematuria and anemia

Francesco Ripa; Lorenzo Rocchini; Luca Boeri; Emanuele Montanari

doi:10.1016/j.eucr.2020.101420

A case of acute bleeding from a small, asymptomatic renal angiomyolipoma (AML) during pneumoperitoneum induction for a rectal tumor resulting in acute hematuria and anemia

Urol Case Rep. 2020 Sep 21:33:101420. doi: 10.1016/j.eucr.2020.101420. eCollection 2020 Nov.

Authors

Francesco Ripa¹, Lorenzo Rocchini¹, Luca Boeri¹, Emanuele Montanari¹

Affiliation

¹ Department of Surgery - Division of Urology and Department of Clinical Sciences and Community Health. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and University of Milan, Italy.

Abstract

Angiomyolipoma (AML) is a benign renal mesenchymal tumor. Active surveillance is considered the most appropriate option for most AMLs. The major complication of AML is its spontaneous bleeding in the retroperitoneum that could be life-threatening for the patient. In this case, acute bleeding from a sporadic AML was reported immediately after the induction of a 12 mmHg pneumoperitoneum during a planned laparoscopic resection of the rectum for oncological reasons. After immediate stabilization the patient underwent angiography of the renal artery and super-selective vascular embolization. Although rare, spontaneous rupture of asymptomatic AML should always be considered, especially in intraoperative setting.

Keywords: Angiomyolipoma; Embolization; Hemorrhage; Kidney cancer; Pneumoperitoneum; Surveillance.

Publication types

Case Reports