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After nephron-sparing surgery (NSS), postsurgical fatty tumor could be mistakenly reported as angiomyolipoma during radiologic imaging of some patients. In the present paper, we studied the postsurgical fatty tumor detected after NSS but not covered before in the literature. In addi-tion, we also evaluated whether the postsurgical fatty tumor was related to the surgical technique employed. Patients admitted to the urology department of our university hospital from 2014 to 2019 and operated with open NSS were evaluated retrospectively. We detected those 156 patients were operated with NSS. Nine patients with angiomyolipoma as primary pathology and four patients with surgical border positivity were excluded from the study. The patients were divided into two groups based on the repair of tumor extraction region. In Group 1, fatty tissue was used for repair, and Group 2 is the primary repair group. In all, 143 patients (Group 1 = 79, and Group 2 = 64) were included in the study. No demographic and radiologic differences, such as number of patients, age, gender, positioning of tumor, mass localization, tumor diameter, and RENAL nephrometry scoring system, were detected between the two groups. Postsurgical fatty tumors were detected in 28 patients in Group 1 and in two patients in Group 2 (P < 0.001). In patients with negative surgical margins after partial nephrectomy, lesions that were radiologically detected mimicking as angiomyolipoma were defined as “postsurgical fatty tumor.” This mass containing adipose tissue only nei-ther depicted vascularization and enhancement nor increase in size for at least 1 year. We assumed that these lesions must be followed as benign lesions not requiring additional treatment.

Giant angiomyolipoma (AML) is uncommon benign renal neoplasm that occurs sporadic or in association with tuberous sclerosis syndrome. There is no specific cutoff tumor size and/or weight to define giant AMLs. Ovarian stimulation hormones might cause a marked increase in its size and subsequent bleeding risk. Incidental findings are not common in those patients as mass-associated symptoms always present. Computed tomography scan is the standard diagnostic imaging study except for tumors with poor fat content. According to the clinical presentation, site and side of renal involvement giant sporadic AMLs have different treatment options, for example, active surveillance, selective renal artery embolization, nephron-sparing surgery, and/or radical nephrectomy. In the present case report, we present a 22-year-old female with huge right renal mass (29 cm × 23 cm × 21 cm) and treated with right radical nephrectomy which proved to be renal AML on pathology examination.

INTRODUCTION AND OBJECTIVE:Angiomyolipomas (AMLs) are the most common benign renal neoplasm with a strong female predilection, and occur as sporadic, isolated entities in the majority of cases. Amo...

Metanephric adenoma is an uncommon benign renal neoplasm which typically occurs in the adult population. Although calcification is a common finding, osseous metaplasia is uncommon and may cause diagnostic difficulty on preoperative radiological imaging. Bone marrow elements (i.e. haematopoietic cells and adipose tissue) have been described in renal cell carcinomas but to our knowledge not in metanephric adenoma. We present a case of a 75-year-old woman diagnosed with a metanephric adenoma with the unusual finding of associated bone and bone marrow elements. To our knowledge, this is the first case report of bone marrow elements seen in association with metanephric adenoma. Keywords: Metanephric adenoma, Bone, Bone marrow, Osseous metaplasia, Extramedullary haematopoiesis, Kidney

WOS: 000435448100012 Renal angiomyolipoma (R-AML) is one of the most common benign neoplasms of the kidney. It is usually asymptomatic and rarely becomes symptomatic. Management of R-AML is still controversial. Generally, follow-up is enough for the management of the disease but rarely, life-threatening complications may develop. Here, we would like to present a case of huge R-AML with life-threatening bleeding with literature review.

Renal angiomyolipomas are rare type of benign renal neoplasm. They are composed of vascular, smooth and fat elements and can be associated to phacomatosis as Tuberous Sclerosis disease. Symptomatic presentation is most frequently spontaneous retroperitoneal hemorrhage, which can be fatal. The risk of bleeding is proportional to the size of the lesion (>4 cm of diameter). Typical angiomyolipomas are benign but may have alarming properties: nuclear pleomorphism and mitotic activity, extension into the vena cava, and spread to regional lymph nodes without malignant progression. We report a Computed Tomography finding of a rare giant bilateral angiomyolipomas with spontaneous hemorrhage and inferior vena cava thrombus in a patient with tuberous sclerosis, emphasizing the importance of imagery in the positive and etiologic diagnosis.

Metanephric adenoma is a rare and benign renal neoplasm originating in the epithelial cells of the kidney. The tumor has a benign course and a characteristic histopathological appearance, typically exhibiting a solid and poorly-demarcated margin with rare cystic components or calcifications. However, it is often difficult to distinguish metanephric adenoma from malignant neoplasms prior to surgical resection. To the best of our knowledge, only one case of metastasis to the lymph nodes has been described in the literature thus far. The present study retrospectively analyzed one case of surgically and pathologically-confirmed atypical metanephric adenoma. Clinical and pathological analysis, as well as computed tomography scans, revealed a mass with a clearly defined margin and diffuse calcifications. The mass was subsequently resected and the patient recovered well following the procedure.

Background: Angiomyolipoma (AML) is a benign renal neoplasm. First-line therapy includes renal preserving surgery or angioembolization (RAE), both with good outcomes in isolated studies. However, there are no comparative randomized trials and no clinical guidelines to help clinicians decide between these treatment modalities. Our study examines the patterns of AML treatment at a tertiary care centre to evaluate how local urologists have been treating this disease. Methods: This is a retrospective study of all AMLs treated at the Vancouver General Hospital (Vancouver, BC, Canada) over the past 10 years with either RAE or surgical excision. Searches were performed of the radiology and pathology dictation systems, using the following keywords: AML, angiomyolipoma, angioembolization, embolization, surgery, partial nephrectomy and nephrectomy. Results: At our institution, more AMLs were treated by surgery than angioembolization (42 vs. 17 cases). Angioembolization was more often chosen for cases of multifocal AML (35% vs. 7%) and acute hemorrhage (50% vs. 14%). In the angioembolization cases, particles were the embolic agent of choice (used 40% of the time). Conclusions: Angioembolization allows rapid patient stabilization in cases of acute hemorrhage, and provides good renal preservation in cases of multifocal AML. It may also be preferred in large masses when partial nephrectomy is not feasible. Surgery should be performed in cases of diagnostic uncertainty or complex vascular anatomy not amenable to RAE. Prospective randomized studies are needed to compare RAE and surgery to better define their indications in sporadic AML. Contexte : Un angiomyolipome (AML) est une tumeur benigne du rein. Le traitement de premiere intention comprend une chirurgie de conservation renale ou une angioembolisation renale, qui ont toutes deux donne de bons resultats dans des etudes isolees. Cependant, aucun essai comparatif randomise n’a ete mene et il n’existe pas de lignes directrices pour aider les cliniciens a choisir entre ces modalites therapeutiques. Notre etude a examine les tendances dans le traitement de l’AML a un centre de soins tertiaires pour evaluer comment les urologues y traitent cette maladie. Methodologie : Il s’agit d’une etude retrospective de tous les AML traites au Vancouver General Hospital (Vancouver, C.-B., Canada) au cours des 10 dernieres annees, soit par chirurgie de conservation renale ou par angioembolisation. Des recherches ont ete effectuees dans les systemes de dictee vocale de radiologie et de pathologie en utilisant les mots-cles anglais suivants : AML, angiomyolipoma, angioembolization, embolization, surgery, partial nephrectomy et nephrectomy. Resultats : Dans notre etablissement, plus de cas d’AML ont ete traites par chirurgie que par angioembolisation (42 cas contre 17). L’angioembolisation a ete plus souvent choisie dans les cas d’AML multifocal (35 % contre 7 %) et d’hemorragie aigue (50 % contre 14 %). Dans les cas traites par angioembolisation, les particules ont ete l’agent embolique privilegie (utilisees dans 40 % des cas). Conclusions : L’angioembolisation permet de stabiliser rapidement l’etat du patient en cas d’hemorragie aigue, et offre une bonne conservation renale en cas d’AML multifocale. Elle peut aussi etre preferable en presence de larges masses quand la nephrectomie partielle n’est pas possible. La chirurgie doit etre realisee en cas d’incertitude diagnostique ou d’anatomie vasculaire complexe ne se pretant pas a l’angioembolisation renale. Des etudes prospectives randomisees sont necessaires pour comparer l’angioembolisation renale et la chirurgie afin de mieux definir leurs indications dans les formes sporadiques d’AML.

Metanephric adenoma is a benign renal neoplasm with morphologic features similar to those of malignant renal neoplasms, such as papillary renal cell carcinoma (RCC) and Wilms' tumor. Different methods have been used to distinguish between metanephric adenoma and papillary RCC and Wilms' tumor. However, some techniques are not always available, such as certain immunohistochemical stains, cytogenetics, molecular genetics, and electron microscopy. In the current study, we compared the expression of S100 protein in 15 cases of metanephric adenoma, 10 cases of Wilms' tumor, and 13 cases of papillary RCC. Our results revealed strong expression of S100 proteins in all cases of metanephric adenoma, weak expression in two cases of Wilms' tumor, and no expression in any of the cases of papillary RCC. These findings indicate that S100 could be a useful and accessible tool for the diagnosis of metanephric adenoma.

Background Renal oncocytoma is an uncommon tumor, classified as a benign renal neoplasm in the World Health Organisation classification of renal tumours. Despite it there were described several reports with invasive histopathologic features. Case report We describe a case of renal oncocytoma with bizzare cells and invasion of renal sinus fat tissue. We performed immunohistochemical analysis of the case and a review of relevant literature. Conclusion In order to set up the right dia-gnosis the perfect co- operation of clinicians and pathologists is necessary. In our opinion, in accordance with other authors, the renal oncocytomas should be considered as having a very low rather than no malignant potential, in spite of clinically benign behavior, supplementing a hypothesis, whether renal oncocytomas may be considered as a precancerous lesion of chromophobe carcinoma.

Bilateral cystic nephroma is an extremely rare benign renal neoplasm. Here we present a case of bilateral cystic nephroma in a four month old boy who subsequently developed embryonal rhabdomyosarcoma of the urethra. Both tumors were successfully treated. To our knowledge this is the first reported case of this association which could be related to Dicer-1 mutation.

Metanephric adenoma (MA) is a rare benign renal neoplasm of originating in the epithelial cells, which is often difficult to distinguish from malignant neoplasms preoperatively. In this study we present two cases of patients with MA with the aim to analyze the clinical manifestations, imaging, pathology, diagnosis and treatment of MA. Computed tomography (CT) of the first case revealed a solid well-demarcated tumor, 5.5 × 5.4 cm in diameter. Ultrasound examination of the second patient revealed a hypoechoic mass with solid aspect and irregular limits in the upper pole of the right kidney. CT confirmed the presence of a 4 cm expansive tumoral formation with intermediate attenuation and minimum venous contrast enhancement at that anatomic site. The two cases underwent surgery and the patients were free from recurrence after a follow-up period of 18 months to 2 years. We also present a supplementary review of previously published cases and related literature.

Renal angiomyolipoma (AML) is a benign renal neoplasm with the exception of the rare epithelioid variant. AML may be sporadic or may be associated with tuberous sclerosis complex or pulmonary lymphangioleiomyomatosis. Risk of

Fallbericht. Wir berichten uber einen 2-jahrigen Jungen mit zunehmender Inappetenz und Gewichtsabnahme seit einigen Wochen. Bei der korperlichen Untersuchung fiel eine tastbare Resistenz im linken Oberbauch auf. Sonographisch war die Raumforderung der linken Niere zuzuordnen.Diese war weitgehend durch multiple, irregular angeordnete und begrenzte Zysten ersetzt, die durch unterschiedlich dicke Septen voneinander abgegrenzt waren.Das sonographische Bild war pathognomonisch fur ein multilokulares zystisches Nephrom,was sich nach Nephrektomie histologisch bestatigte. Schlussfolgerung. Die Diagnose multilokulares zystisches Nephrom kann mit hoher Sicherheit sonographisch gestellt werden, die Therapie ist ausschlieslich chirurgisch, die Prognose gut.

Angiomyolipoma (AML) is a benign renal neoplasm derived from perivascular epithelioid cells and composed of fat, and vascular and smooth muscle element besides spindle cells. It has an incidence of 0.3 - 3% and has increased due to advances in imaging modalities. The overall female to male ratio is approximately 4:1 which is suggesting hormonal component to tumor growth. It can occur sporadically or may be associated with tuberous sclerosis complex. We present a case of renal angiomyolipoma in a 28 year old woman who presented with symptoms of pain off and on and the diagnosis was based on the computed tomography and was confirmed on histopathology.

Mixed Epithelial and Stromal Tumor of the Kidney Sun Il Kim, Sung Ryong Kim, Soo Hyung Lee, Hee Jae Joo, Sung Hoon Park, Se Joong Kim From the Departments of Urology and Pathology, Ajou University School of Medicine, Suwon, Korea Mixed epithelial and stromal tumor of the kidney (MEST) is a rare, recently described benign renal neoplasm that predominantly affects perimenopausal women. It is composed of dual components of epithelial and stromal cells, and the tumor is characterized by admixed cystic and solid growth patterns. Herein, we report on a case of MEST in a 35-year-old woman who presented with an incidentally found renal tumor. The patient has had no evidence of disease 4 years after the surgery. (Korean J Urol 2008;49:174-176) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Angiomyolipoma has been regarded as a benign renal neoplasm composed of adult fat cells, atypical blood vessels and smooth muscle. We report a case in which a renal angiomyolipoma showed clear evidence of involvement of the spleen and regional lymph nodes. The consensus in the literature suggests that this phenomenon is a manifestation of the multicentric nature of angiomyolipoma, rather than metastasis.