PMC7229267_01
Axial section of abdominal CAT scan showing.. A. Multilobulated hypodense (fatty tissue density) in the right kidney.. B. Hypodense signal in the IVC, sharing the same fatty density as the tumor.
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Abdominal computed axial tomography (CAT) scan revealed a 3 cm lobulated low-density lesion in the renal sinus, middle and upper lobes of the right kidney (Fig. 1).
Coronal sections of abdominal angioscan revealing low density lesion extending into the IVC, reaching above the diaphragm superiorly.
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On abdominal angioscan, the low-density lesion extended from the right kidney into the right renal vein and IVC, reaching above the diaphragm superiorly, 3 cm below the right atrium (Fig. 2).
Using a median sternotomy combined with a right subcostal incision, extended shortly towards the left, we had good exposition of the right kidney (K) and the heart (H) and control over the inferior vena cava.
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Right subcostal approach with median sternotomy was used (Fig. 3).
After cavotomy of the inferior vena cava (IVC), the tumor (T) is taken out in one piece with the right kidney (K).
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The tumor was taken in one piece with the right nephrectomy (Fig. 4, Fig. 5, Fig. 6, Fig. 7).
Coronal incision of the right kidney revealing the fatty tumor in the renal pelvis. The thrombus here is shown behind the kidney and is of the same gross appearance as the renal tumor.
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The tumor was taken in one piece with the right nephrectomy (Fig. 4, Fig. 5, Fig. 6, Fig. 7).
Positive staining of smooth muscle component and of vessel walls with anti-SMA antibodies.
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These characteristics were compatible with that of a benign AML, which was confirmed by immunohistochemistry: positive staining with anti-SMA antibodies (Fig. 8) and anti-HMB45 and (Fig. 9), and negative staining with anti-CD34 and anti-CKAE1/AE3 antibodies (Fig. 10).
The normal renal tissue stains positive for anti-CK antibodies. This stain marking the epithelial component is negative in the tumor tissue. This marker would have been positive in the tumor in case of renal cell carcinoma or epitheloid AML.
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These characteristics were compatible with that of a benign AML, which was confirmed by immunohistochemistry: positive staining with anti-SMA antibodies (Fig. 8) and anti-HMB45 and (Fig. 9), and negative staining with anti-CD34 and anti-CKAE1/AE3 antibodies (Fig. 10).