Introduction. A kidney’s angiomyolipoma is a highly active vascular tumor, usually benign, consisting of endothelial cells, smooth muscles and adipose tissue, originally originating from mesenchymal tissue. It can affect various organs – the liver, uterus, vagina, penis, hard palate, colon. Both the cortical and medulla of the kidney are affected. The prevalence ranges from 0.2–0.6%, mainly affecting women.
Clinical case. A 62-year-old patient was hospitalized with intense lumbar pain. Hemoglobin was 97 g/l. Ultrasound and CT revealed a left renal mass up to 10.2 cm with signs of hemorrhage. An emergency nephrectomy was performed. An angiomyolipoma was verified during histological examination. The postoperative period is uncomplicated.
Discussion. This article demonstrates one of the kidneys’ angiomyolipoma complications, which was asymptomatic for a long time and debuted with hemorrhage. This patient required hospitalization and emergency surgery. It is possible to use X-ray endovascular embolization; however, this technique requires special equipment and specialists of the appropriate profile. In addition, after its use, recurrent bleeding is possible, and therefore, in our opinion, with large angiomyolipoma complicated by spontaneous rupture and bleeding, open (or laparoscopic) surgery is more appropriate.
Conclusion. Even though angiomyolipoma is a benign formation, with its large size, spontaneous tumor rupture is possible with the development of life-threatening bleeding. This clinical case indicates that active surgical tactics are justified in patients with large angiomyolipoma.
