Late Recurrence of Metastatic Pancreatic Angiomyolipoma in Tuberous Sclerosis Following Bilateral Nephrectomy and Transplant

Recurrent angiomyolipomas are rare, particularly in the pancreas of patients with tuberous sclerosis (TSC). We report a 59-year-old woman with TSC who underwent bilateral nephrectomy for malignant, hemorrhagic angiomyolipomas with subsequent renal transplant. Almost 10 years after initial discovery of renal angiomyolipoma, the patient was found to have a pancreatic tail angiomyolipoma on endoscopic ultrasound performed for the evaluation of abnormal liver enzymes. The mass was not visualized on previous imaging. This case highlights the possible role of endoscopic ultrasound in continued surveillance for recurrent angiomyolipoma after nephrectomy in patients with TSC.