À propos d’une masse rénale droite

We report a case of a 44-year old female patient with right back pain, apyretic, without associated signs. Clinical examination showed good overall physical condition without pain in the costovertebral angle region. Lymph nodes were free. The patient underwent abdominal ultrasound and abdominal computed tomography (CT) scan which showed a lesion process measuring 09 cm along its longer axis, in the right renal lodge, roughly defined encapsulated, heterogeneous, containing calcified bulkheads. This mass was in close contact with the lower edge of the liver which was the seat of three hypodense lesions. magnetic resonance imaging (MRI) showed: spontaneously T1-hyperintense lesion (a), heterogeneous in T2 (b,c), containing few diffusion hypersignals (d). After Gadolinium injection (e) and on subtracted sequences (f) there was no fleshy component while there was peripheral contrast enhancement. The three hepatic lesions were consistent with sclerosing angiomas. Histological examination of the specimen obtained from ultrasound-guided renal biopsy showed angiomyolipoma. Angiomyolipomas are benign slow growing tumors, characterized by a proliferation of adipose tissue, vascular elements, muscle fibers in variable proportions. Abdominal CT scan is the examination of choice to make a positive diagnosis of angiomyolipoma in the vast majority of cases. Diagnosis is difficult in patients with uncommon forms, including those with no greasy component (almost pathognomonic), and with intra-tumor bleeding masking the various contingents. Differential diagnosis includes renal cancers and other benign tumors of the kidney.