The pre-operative diagnosis of renal hamartoma

The characteristic angiographic findings in renal hamartoma consist of: a large dilated feeding vessel passing through the mass, multiple multisacculated aneurvsmal dilatations (bunch of grapes), a delicate discrete discrete neovascularity without A-V shunting, and 'onion peeling' on the venous phase. In addition radiolucent areas within the renal mass indicate a high fat content. When these findings are present renal hamartoma can be diagnosed confidently. Racial nephrectomy and needless sacrifice of a whole kidney for a benign lesion can be avoided. Heminephrectomy may be sufficient, thus saving the patient valuable renal tissue. Four cases of renal hamartoma are presented. Plain film and angiographic studies are shown. All four showed the characteristic angiographic findings of renal hamartoma and were diagnosed pre-operatively.