Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2020; 8(12): 2502-2509
Published online Jun 26, 2020. doi: 10.12998/wjcc.v8.i12.2502
Magnetic resonance imaging features of minimal-fat angiomyolipoma and causes of preoperative misdiagnosis
Xiao-Long Li, Li-Xin Shi, Qi-Cong Du, Wei Wang, Li-Wei Shao, Ying-Wei Wang
Xiao-Long Li, Qi-Cong Du, Wei Wang, Li-Wei Shao, Ying-Wei Wang, Department of Radiology, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Li-Xin Shi, Department of Urology Surgery, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Author contributions: Li XL and Shi LX contributed equally to this article and should be considered as co-first authors; Li XL and Du QC performed the operation; Li XL and Shi LX designed this retrospective study; Du QC and Wang W wrote this paper; Wang W and Shao LW were responsible for sorting the data.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Chinese People’s Liberation Army General Hospital.
Informed consent statement: Informed consent was obtained from the patients.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Ying-Wei Wang, PhD, Attending Doctor, Department of Radiology, First Medical Center of Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China. wangyw301@163.com
Received: February 24, 2020
Peer-review started: February 24, 2020
First decision: March 27, 2020
Revised: April 10, 2020
Accepted: May 19, 2020
Article in press: May 19, 2020
Published online: June 26, 2020
Abstract
BACKGROUND

Minimal-fat angiomyolipoma (mf-AML) is often misdiagnosed as renal cell carcinoma before surgery.

AIM

To analyze the magnetic resonance imaging (MRI) features of mf-AML and the causes of misdiagnosis by MRI before operation.

METHODS

A retrospective analysis was performed on ten patients with mf-AML confirmed by surgical pathology, all of whom underwent preoperative MRI examination to analyze the morphological characteristics and MRI signals of the tumor.

RESULTS

MRI revealed a circular-like mass in 4/10 (40%) patients, an oval mass in 6/10 patients (60%), a mass with a capsule in 9/10 patients (90%), and a mass with a lipid component in 7/10 patients (70%). The diameter of the masses in all ten patients was from 11 to 47 mm; the diameter was between 11 mm and 40 mm in 8/10 (80%) patients and between 40 mm and 47 mm in 2/10 (20%) patients.

CONCLUSION

An oval morphological characteristic is strong evidence for the diagnosis of mf-AML, while a capsule and lipids are atypical manifestations of mf-AML.

Keywords: Minimal-fat angiomyolipoma, Magnetic resonance imaging, Misdiagnosis, Preoperative diagnosis

Core tip: In magnetic resonance imaging, the oval or round-like morphological features, particularly oval or ellipse features, are of great significance for the diagnosis of minimal-fat angiomyolipoma. Capsules, lipid composition, and washout are atypical manifestations of minimal-fat angiomyolipoma.