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Abstract

Introduction: The angiomyolipoma of renal origin is a rare benign tumor composed of fat cells, smooth muscle cellsand thickwall blood vessels. Mostly these are sporadic origin asymptomatic and benign in nature. Case series: Here we are presenting a case series of renal angiomyolipoma (AML) presenting as fever, pain, perirenal hematoma and frank hematuria. After initial stabilization evaluated by contrast enhanced computer tomography anddiagnosed as renal angiomyolipomabecause of low Hounsfield areas (10-20HU) suggestive for fat. Patient later underwent angiography which showed multiple aneurysmal dilations,arteriovenousfistulae and actively bleeding vessels were identified and controlled with selective angioembolisation Post intervention period was uneventful and was treated by an oral Everolimus 10 mg daily for a period of 1 year in first case and partial resection was done in second case. On two year follow-up both patient were doing well and had normal renal function without any recurrence. Conclusion:Embolization is the emergency treatment of choice for bleeding angiomyolipoma. When preventive treatment is considered a nephron-sparing approach either by transarterial embolization or partial nephrectomy is clearly important.While angiomyolipoma in both kidneys or in solitary functioning kidneys, renal preservation is mandatory in order to avoid need for renal replacement therapy.Also recently approved drugEverolimus may be considered for patients not suitable for surgery particularly in tumour seen with tuberous sclerosis.

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