Giant Renal Artery Aneurysms: Decision-Making Dilemmas

A case of a 10 cm giant renal artery aneurysm in an 81-year-old lady is herein reported. The patient presented as an incidental finding on an abdominal ultrasound with an aneurysm which was large, soft, egg-shell-like, and bilobular with a cauliflower-type pattern invading the parenchyma of the renal substance and extending caudally. A right nephrectomy was carried out, and the patient made an uneventful recovery. This paper reviews the options for treatment of giant renal artery aneurysms and highlights the benefit of a planned nephrectomy once there is adequate renal reserve in the opposite kidney using a midline approach for right-sided giant renal artery aneurysms and a left-sided flank approach for left-sided aneurysms.