0:00

Okay, so here's our case of the retroperitoneal

0:03

bleeding within the perirenal space, around

0:06

and posterior to the kidneys, but without

0:08

increasing in size of the iliopsoas musculature.

0:11

This is a result from a small bleeding AML, or

0:15

angiomyolipoma, of the inferior pole of the kidney.

0:18

This would be a perfect opportunity for your

0:20

interventional colleagues to get their grace on

0:22

and go in and embolize this bleeding renal lesion.

0:26

So renal AMLs, they're pretty

0:28

common, um, in the population.

0:30

They're benign renal neoplasms.

0:32

They can be composed of many different

0:33

kinds of soft tissue stroma, including

0:35

vascular, smooth muscle, and fatty elements.

0:38

The fat is kind of the classic at imaging, or that

0:40

they have macroscopic, or large amounts of fat.

0:44

They are associated with tuberous sclerosis,

0:47

though they can be sporadic as well.

0:49

I think they're more commonly sporadic.

0:51

At Mass General, we have a big tuberous sclerosis

0:53

referral center, so we see extremely large AMLs

0:56

that are oftentimes treated, very complex treatments,

0:59

for those patients with our interventional teams.

1:02

So you're going to look for a large, fatty renal lesion.

1:04

This one, indeed, as well, is bleeding.

1:07

They can hemorrhage spontaneously.

1:09

The risk of hemorrhage increases as they

1:11

increase in size over four centimeters.

1:13

So sometimes they will be embolized once they hit

1:16

four centimeters to be conservative and hope that

1:18

they don't have a spontaneous bleed in the future.

1:20

So this is a bleeding AML, renal angiomyolipoma,

1:25

causing retroperitoneal bleeding in that perirenal

1:28

space that's so associated with the kidney.

Angiomyolipoma

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