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Kyriakos Saad M, Sader G, Saikaly E. Angiomyxolipoma of the spermatic cord: A case report. Clin Case Rep 2024; 12:e8971. [PMID: 38799528 PMCID: PMC11126641 DOI: 10.1002/ccr3.8971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/25/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
Lipomas are considered one of the most frequent benign mesenchymal tumors with copious variants. Among these variants is angiomyxolipoma (AML) which is considered an extremely rare entity. To the best of our knowledge, only 19 cases have been reported in the English medical literature, of which three of them involving the spermatic cord. Herein, we report the fourth case of a 37-year-old male patient with angiomyxolipoma (AML) of the spermatic cord discovered incidentally during elective hernia repair.
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Affiliation(s)
| | - Georgio Sader
- Faculty of MedicineUniversity of BalamandBeirutLebanon
| | - Elias Saikaly
- Department of General SurgerySaint George Hospital University Medical CenterBeirutLebanon
- Saint George University of BeirutBeirutLebanon
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Dong A, Yang B, Yang Q, Cheng C, Zuo C. 68Ga-FAPI-04 PET/MRI in a Case of Tuberous Sclerosis Complex With Extrarenal Retroperitoneal Angiomyolipoma. Clin Nucl Med 2023; Publish Ahead of Print:00003072-990000000-00593. [PMID: 37276549 DOI: 10.1097/rlu.0000000000004737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
ABSTRACT Extrarenal retroperitoneal angiomyolipomas are rare benign tumors that may mimic other benign or malignant retroperitoneal tumors. We describe 68Ga-FAPI-04 PET/MRI findings in a case of tuberous sclerosis complex with an extrarenal retroperitoneal angiomyolipoma and multiple angiomyolipomas involving bilateral kidneys. The extrarenal retroperitoneal angiomyolipoma and most of the renal angiomyolipomas were 68Ga-FAPI-04-avid. One left renal angiomyolipoma with extensive hemorrhage and fibrosis had no significant 68Ga-FAPI-04 uptake. Angiomyolipoma should be included in the differential diagnosis of FAPI-avid renal or extrarenal retroperitoneal lesions.
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Affiliation(s)
| | - Bo Yang
- Urology, The First Affiliated Hospital of Naval Medical University (Changhai Hospital), Shanghai, China
| | | | - Chao Cheng
- From the Departments of Nuclear Medicine
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Ayoub K, Rakab A, Shibani M, Bohsas H, Alibrahim H, Swed S, Rais MA, Sawaf B, Mahli N. An asymptomatic giant extra-renal retroperitoneal angiomyolipoma: Case report. Medicine (Baltimore) 2022; 101:e31869. [PMID: 36626540 PMCID: PMC9750637 DOI: 10.1097/md.0000000000031869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
RATIONALE Angiomyolipoma is a benign mesenchymal tumor that consists of adipose tissue, muscle cells and blood vessel. Renal angiomyolipomas represent almost one percent of all renal tumors. PATIENT CONCERNS We reported a case of a 42-year-old woman complaining of mild abdominal pain with no other symptoms and no remarkable medical history. DIAGNOSIS Clinical examination was inconclusive and revealed a large, smooth, non-tender, and immovable mass in the right abdomen. Ultrasound examination confirmed the existence of a large, homogeneous, hyperechoic tissue mass. Abdominal multi-slice computed tomography (CT) scans also confirmed the presence of a well-rounded mass in the right abdomen. The histopathology tests confirmed the diagnosis of a large retroperitoneal mass. INTERVENTIONS The patient underwent a traditional laparotomy without complications to remove the tumor. OUTCOMES The open surgery was the best option, and the patient's condition improved due to the following-up. LESSONS Retroperitoneal extra-renal angiomyolipomas are extremely rare, and in this case, we document a case of retroperitoneal angiomyolipoma manifested with only mild abdominal pain in Syrian women.
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Affiliation(s)
- Kusay Ayoub
- Department of Surgery, Aleppo University Hospital, Aleppo, Syria
| | - Amine Rakab
- Medicine, Weill Cornell Medical College, Qatar
| | - Mosa Shibani
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | | | | | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
- * Correspondence: Sarya Swed, Faculty of Medicine, Aleppo University, Aleppo, Syria (e-mail: )
| | | | - Bisher Sawaf
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Nihad Mahli
- Department of surgery, Aleppo University Hospital, Aleppo, Syria
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Dutta S, Marbaniang E, Dey B, Lyngdoh BS, Raphael V. Angiomyolipoma of the broad ligament. AUTOPSY AND CASE REPORTS 2020; 10:e2020173. [PMID: 33344297 PMCID: PMC7703467 DOI: 10.4322/acr.2020.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Angiomyolipoma is a benign mesenchymal neoplasm of the renal parenchyma, accounting for 1% of all renal parenchymal tumors. However, this entity may rarely occur in extrarenal sites. Extrarenal angiomyolipoma has been documented in various sites of the body, but angiomyolipoma of the broad ligament was reported in only two cases. We report the reputed third case of angiomyolipoma of the broad ligament in a 33-year-old female, who presented clinically with abdominal distension. With a working diagnosis of low-grade neoplasm, an en-bloc excision of the left broad ligament mass was performed. Based on histopathology and immunohistochemistry, a diagnosis of the classical variant of angiomyolipoma of the left broad ligament was made. The post-operative period was uneventful with no recurrence after 6 months of follow-up.
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Affiliation(s)
- Satya Dutta
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Evarisalin Marbaniang
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Biswajit Dey
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Bifica Sofia Lyngdoh
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
| | - Vandana Raphael
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Department of Pathology. Shillong, India
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Giant Extrarenal Retroperitoneal Angiomyolipoma: A Rare Case of a Large Size Tumor. Clin Genitourin Cancer 2018; 16:e1025-e1027. [PMID: 29980448 DOI: 10.1016/j.clgc.2018.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 06/04/2018] [Indexed: 11/24/2022]
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Ghimire O, Wenzheng L, Huaping L, Wenguang L, Yigang P, Jiale H. Angiomyolipoma of the Adrenal Gland: A Report of Two Cases and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:989-994. [PMID: 28904331 PMCID: PMC5608147 DOI: 10.12659/ajcr.903908] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Angiomyolipoma is a benign tumor composed of blood vessels, smooth muscle cells, and adipose tissue and has been described as belonging to the group of tumors of perivascular epithelioid cell origin (PEComa), commonly found in the kidneys and strongly associated with tuberous sclerosis. Only a few cases of extra-renal angiomyolipoma have previously been reported in the literature, most commonly in the liver. Adrenal angiomyolipoma is very rare, is usually asymptomatic, and is often found incidentally, with only 14 previously reported cases identified in the literature. CASE REPORT We report two cases of adrenal angiomyolipoma that were identified by abdominal computed tomography (CT). The first case presented in a 36-year-old man and was an oval-shaped adrenal mass, measuring 5.2×4.2×3.1 cm. The second case presented in a 61-year-old woman and was a round-shaped mass measuring 8.6×9.5×8.1 cm. Both patients underwent adrenalectomy. Histopathology and immunohistochemistry confirmed the diagnosis of benign angiomyolipoma composed of adipose tissues, blood vessels, and smooth muscle cells. CONCLUSIONS We present two rare cases of adrenal angiomyolipoma. We have reviewed the literature and identified 14 other cases of adrenal angiomyolipoma, and discuss the clinical, radiological, and pathological features of this rare tumor.
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Affiliation(s)
- Obin Ghimire
- Department Of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Li Wenzheng
- Department Of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Liu Huaping
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Liu Wenguang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Pei Yigang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Hou Jiale
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
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Venyo AKG. A Review of the Literature on Extrarenal Retroperitoneal Angiomyolipoma. Int J Surg Oncol 2016; 2016:6347136. [PMID: 26989509 PMCID: PMC4773571 DOI: 10.1155/2016/6347136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 01/02/2016] [Accepted: 01/05/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Extrarenal retroperitoneal angiomyolipomas are rare. AIM To review the literature. RESULTS Angiomyolipomas, previously classified as hamartomas, are now classified as benign tumours. Thirty cases of primary retroperitoneal angiomyolipomas have been reported. Diagnosis of the disease upon is based radiological and pathological findings of triphasic features of (a) fat and (b) blood vessels and myoid tissue. Immunohistochemistry tends to be positive for HMB45, MART1, HHF35, calponin, NKI-C3, and CD117. The lesion is common in women. Treatment options have included the following: (a) radical surgical excision of the lesion with renal sparing surgery or radical nephrectomy in cases where malignant tumours could not be excluded and (b) selective embolization of the lesion alone or prior to surgical excision. One case of retroperitoneal angiomyolipoma was reported in a patient 15 years after undergoing radical nephrectomy for angiomyolipoma of kidney and two cases of distant metastases of angiomyolipoma have been reported following radical resection of the tumour. CONCLUSIONS With the report of two cases of metastases ensuing surgical resection of the primary lesions there is need for academic pathologists to debate and review angiomyolipomas to decide whether to reclassify angiomyolipomas as slow-growing malignant tumours or whether the reported cases of metastases were de novo tumours or metastatic lesions.
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Absence of Statistical Analysis in a Retrospective Study of Retroperitoneal Neoplasm. AJR Am J Roentgenol 2012; 199:W420; author reply W421. [DOI: 10.2214/ajr.12.8770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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P N S, M S, S G, Sharma SK. Acute abdomen as an unusual presentation of broad ligament angiomyolipoma. A case report and review of literature. Indian J Surg Oncol 2012; 3:276-8. [PMID: 24293961 DOI: 10.1007/s13193-012-0169-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 06/08/2012] [Indexed: 11/28/2022] Open
Affiliation(s)
- Shakuntala P N
- Department of Obstetrics and Gynaecology, St. Martha's Hospital, Bengaluru, India
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Retroperitoneal extrarenal angiomyolipomas: an evidence-based approach to a rare clinical entity. Case Rep Nephrol 2012; 2012:374107. [PMID: 24555133 PMCID: PMC3914176 DOI: 10.1155/2012/374107] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 06/21/2012] [Indexed: 12/21/2022] Open
Abstract
Extrarenal angiomyolipomas (ERAMLs) are rare tumors that present as incidentalomas upon imaging for other conditions. Retroperitoneal ERAMLs present a unique challenge from a diagnostic and treatment standpoint as they can mimic other benign and malignant retroperitoneal tumors. We present a case of a 39-year-old female with a 19.3 cm × 13.5 cm × 10.7 cm left extrarenal retroperitoneal mass. Histopathologic examination and HMB-45 staining revealed the mass to be a retroperitoneal ERAML. Our case report provides a comprehensive literature review and an evidence-based algorithm for taking care of patients with ERAMLs.
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A case of angiomyolipoma rarely located in the larynx. Case Rep Otolaryngol 2011; 2011:427074. [PMID: 22957284 PMCID: PMC3420772 DOI: 10.1155/2011/427074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Accepted: 08/08/2011] [Indexed: 11/17/2022] Open
Abstract
Angiomyolipoma is a rare benign mesenchymal tumor, which is mostly renal in origin. A sixty-year-old male patient with the diagnosis of angiomyolipoma located in the larynx has been presented here, and the literature is reviewed.
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Craig WD, Fanburg-Smith JC, Henry LR, Guerrero R, Barton JH. Fat-containing Lesions of the Retroperitoneum: Radiologic-Pathologic Correlation. Radiographics 2009; 29:261-90. [DOI: 10.1148/rg.291085203] [Citation(s) in RCA: 130] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Baskin HJ. The pathogenesis and imaging of the tuberous sclerosis complex. Pediatr Radiol 2008; 38:936-52. [PMID: 18414839 DOI: 10.1007/s00247-008-0832-y] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 03/03/2008] [Accepted: 03/12/2008] [Indexed: 01/08/2023]
Abstract
Tuberous sclerosis complex (TSC) is an autosomal-dominant disorder characterized by the formation of hamartomatous lesions in multiple organ systems. It is the second most common neurocutaneous syndrome after neurofibromatosis type 1 and has been recognized since the late 1800s. Although the disease has complete penetrance, there is also high phenotypic variability: some patients have obvious signs at birth, while others remain undiagnosed for many years. In addition to skin lesions, TSC patients develop numerous brain lesions, angiomyolipoma (AMLs), lymphangiomyomatosis (LAM) in the lungs, cardiac rhabdomyomas, skeletal lesions, and vascular anomalies, all of which are well seen with medical imaging. Our knowledge of TSC genetics and pathophysiology has expanded dramatically in recent years: two genetic loci were discovered in the 1990s and recent elucidation of TSC's interaction with the mTOR pathway has changed how we manage the disease. Meanwhile, medical imaging is playing an increasingly important role in the diagnosis, management, and treatment of TSC. We provide an update on the genetics and pathophysiology of TSC, review its clinical manifestations, and explore the breadth of imaging features in each organ system, from prenatal detection of cardiac rhabdomyomas to monitoring rapamycin therapy to treatment of AMLs by interventional radiology.
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Affiliation(s)
- Henry J Baskin
- Department of Radiology, Cincinnati Children's Medical Center, 333 Burnet Ave., Cincinnati, OH 45229, USA.
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Abstract
Angiomyolipoma is a benign mesenchymal neoplasm that typically occurs in the kidney sporadically or in patients with tuberous sclerosis complex. Extrarenal angiomyolipomas are uncommon, and the liver is the most common extrarenal site. Other sites reported include the bone, colon, heart, lung, parotid gland, skin, spermatic cord, gynecologic regions, and retroperitoneum. A case of an angiomyolipoma involving the right adrenal gland in a 49-year-old female patient with tuberous sclerosis is reported. The magnetic resonance (MR) imaging features are also discussed. Only 2 cases describing adrenal angiomyolipoma were found in the English literature. Neither of these 2 cases was documented in the radiology literature or discussed the MR features of adrenal angiomyolipoma.
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Affiliation(s)
- Khaled M Elsayes
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
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Abstract
Extrarenal angiomyolipoma is an uncommon disease and this may be the first report of angiomyolipoma in the knee, mimicking a malignant sarcoma. A 38-year-old man without tuberous sclerosis presented with a history of increased mass in the knee joint. Computerized tomography and magnetic resonance imaging demonstrated a CS x CS x CR cm subcutaneous tumor in the knee joint. The tumor was widely excised. Histologically, the tumor was, well circumscribed, and composed of smooth muscle, vascular spaces, connective tissue, and mature fat. There were no signs of recurrence at one year and eight months after surgery.
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Affiliation(s)
- Masahito Hatori
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Miyagi, Japan.
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