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Spontaneous rupture of renal angiomyolipoma during pregnancy

Li Ao1, Eriko Ogasahara1, Yasuhiko Okuda1

  • 1Department of Obstetrics and Gynecology, University of Yamanashi, Chuo, Yamanashi, Japan.

BMJ Case Reports
|January 8, 2017
PubMed

A renal angiomyolipoma (AML) is a rare benign tumour of kidney origin. Pregnancy is known to be associated with an increased risk of tumour rupture causing hypovolaemic shock, which is usually managed surgically or through an embolisation procedure. However, having surgery during pregnancy predisposes the mother to a preterm delivery, and the unknown influences of radiation exposure to the fetus make the management of such cases very challenging. A 30-year-old pregnant woman had a sudden onset of gross haematuria at the 20th week of her pregnancy. The MRI showed a 10 cm mass suggestive of AML in the left kidney, with evidence of an intrarenal haematoma. To avoid an iatrogenic preterm delivery and unnecessary fetal exposure to radiation, conservative management was conducted until 34 weeks of gestation, when she came to our hospital reporting of flank pain. An endovascular treatment was performed immediately after an emergency caesarean delivery.

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