INTERNATIONAL JOURNAL OF CLINICAL INVESTIGATION AND CASE REPORTS - Volume 2, Issue 2, (Apr-June)

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Date of Publication: 11-May-2023

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Centrally Thrombosed Renal Angiomyolipoma: A COVID-Induced Pathology?

Author: Adrian A. Naoun* (USA)

Category: Medicine

Abstract:

Renal angiomyolipomas (AMLs) are benign neoplastic entities paradigmatically composed of smooth muscle, blood vessels, and adipose tissue. The cornerstone of renal AML identification fundamentally entails imaging; however, findings may rarely resemble malignancy and subsequently obfuscate diagnosis. Compellingly, the comorbid effect of viral diseases such as COVID-19 on neoplasm integrity and morphology remains incompletely understood. The present case reports a 46-year-old female presenting with intermittent right flank pain persisting for three weeks. Preliminary sonographic studies revealed a predominantly echogenic, space-occupying lesion with well-defined margins in the right renal cortex undergoing angiogenesis. Shortly thereafter, the patient contracted COVID-19, and the right flank pain progressed to a debilitatingly constant nature described as sharp, stabbing, and aggravating to an eight on a scale of ten. Recovery was uncomplicated; however, the patient presented with mild thrombocytopenia. Contrast-enhanced CT scans elucidated a compelling hypodense mass center suggesting the presence of an encapsulated thrombus accompanied by further invasion of Morison’s pouch 25 days post-initial identification. Histopathological examination of the surgically excised specimen confirmed the likely diagnosis of a centrally thrombosed renal angiomyolipoma. Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection may have ostensibly contributed to neoplasm morphology alterations and subsequent thrombosis, as intrinsic renal cell damage is well-documented in the literature. Consequently, clinicians must remain vigilant that radiographic abnormalities may emerge secondary to comorbid viral infections such as COVID-19 via incompletely understood mechanism(s).

Keywords: Angiomyolipoma, COVID

DOI: 10.55828/ijcicr-22-05

DOI URL: http://dx.doi.org/10.55828/ijcicr-22-05

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