Sharma G, Jain A, Sharma P, Sharma S, Rathi V, Garg PK. Giant exophytic renal angiomyolipoma masquerading as a retroperitoneal liposarcoma: A case report and review of literature. World J Clin Oncol 2018; 9(7): 162-166 [PMID: 30425941 DOI: 10.5306/wjco.v9.i7.162]
Corresponding Author of This Article
Pankaj Kumar Garg, MS, DNB, MCh, FACS, Associate Professor, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Dilshad Garden, Delhi 110095, India. dr.pankajgarg@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Gopal Sharma, Ayush Jain, Prerit Sharma, Pankaj Kumar Garg, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
Sonal Sharma, Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
Vinita Rathi, Department of Radiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
Author contributions: Sharma G, Jain A, and Garg PK designed the report; all the authors actively managed the patient; Sharma G, Jain A, and Garg PK collected the patient’s clinical data; Sharma S provided the histopathological images; Rathi V provided the radiological images. All the authors analyzed the case, drafted the manuscript and finally approved it.
Informed consent statement: Consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Pankaj Kumar Garg, MS, DNB, MCh, FACS, Associate Professor, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Dilshad Garden, Delhi 110095, India. dr.pankajgarg@gmail.com
Telephone: +91-11-22692400 Fax: +91-11-22590495
Received: July 6, 2018 Peer-review started: July 6, 2018 First decision: August 21, 2018 Revised: August 12, 2018 Accepted: October 23, 2018 Article in press: October 23, 2018 Published online: November 10, 2018 Processing time: 126 Days and 3.2 Hours
ARTICLE HIGHLIGHTS
Case characteristics
A 42-years-old lady came to our hospital with complaints of abdominal pain and distension of two months duration. The physical examination of the patient revealed large retroperitoneal lump present on the left side of the abdomen.
Clinical diagnosis
The clinical diagnosis was a retroperitoneal mass, likely to be malignant in nature.
Differential diagnosis
The differential diagnosis included retroperitoneal sarcoma, renal neoplasm, multicystic kidney, cold abscess, or hydatid cyst.
Laboratory diagnosis
Routine blood investigations did not reveal any abnormality.
Imaging diagnosis
Abdominal computed tomography revealed a large perirenal mass lesion displaying prominent vessels. There were also two fairly well defined, predominantly fat density rounded lesions in the left kidney; the smaller lesion was continuous with the large perirenal mass.
Pathological diagnosis
Preoperative image guided biopsy of the retroperitoneal mass suggested liposarcoma.
Treatment
In view of preoperative pathological diagnosis of liposarcoma, the patient underwent a margin-negative resection of the retroperitoneal mass (multi visceral resection - enbloc excision of retroperitoneal mass with left nephrectomy and segmental descending colectomy).
Related reports
The final histopathological report of the resected specimen confirmed angiomyolipoma.
Term explanation
AML is a tumor of tri-phasic morphology - blood vessels, smooth muscles, and fat cells. Majority of the AML tumors are benign in nature with almost no malignant potential.
Experiences and lessons
A large exophytic renal AML may be confused with a retroperitoneal sarcoma on a small biopsy specimen. A discordance of the radiological and core biopsy findings in a suspected case of exophytic renal AML must alert the surgeon and a re-evaluation of the case with repeat biopsies may clarify the diagnosis.
