Wünderlich ist nicht so Wunderbar: Bilateral Angiomyolipomas and Wünderlich Syndrome Requiring Emergency Embolization in a Patient without Tuberous Sclerosis

Abstract

Bilateral renal angiomyolipomata are rare and usually associated with tuberous sclerosis. Renal angiomyolipomata can rupture spontaneously giving rise to (potentially catastrophic) retroperitoneal hemorrhage (Wünderlich syndrome). We present a very rare case of bilateral renal angiomyolipomata in an individual without tuberous sclerosis, presenting with life-threatening hemorrhage. The patient had emergency embolization of the bleeding angiomyolipoma and received elective embolization of a contralateral lesion. A follow-up brain magnetic resonance imaging showed no tubers but revealed a pituitary adenoma of uncertain significance.