Wunderlich Syndrome: A Rare Case Associated with Bleeding Renal Angiomyolipoma (AML)

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Renal angiomyolipoma (AML) is a rare benign mesenchymal tumor of the kidney.
• AMLs constitute 1-3% of all solid renal tumors.
• Despite being benign, AML can exhibit aggressive behavior and locoregional extension.

Observation:

• A 60-year-old female presented with left flank pain and unstable blood pressure.
• CT imaging revealed a renal mass with hemorrhagic densities.
• Intraoperative findings confirmed significant bleeding from the renal mass.

Findings:

• The patient underwent radical nephrectomy due to the symptomatic presentation.
• Histopathologic examination confirmed renal AML with secondary changes.
• The clinical presentation and findings were consistent with Wunderlich syndrome, often associated with AML.

Implications:

• This case highlights the importance of considering AML in the differential diagnosis of acute flank pain and renal masses.
• Early detection and prompt surgical management of symptomatic renal AML are critical for preventing life-threatening hemorrhage.
• Increased clinical awareness can improve the timely diagnosis and treatment of renal AML, reducing patient morbidity and mortality.