PMC5622810_01
(A,B) axial abdominal computed tomographic scan showing bilateral abdominal masses of fat attenuation that replace and displace renal parenchyma bilaterally, with a lesion of soft tissue attenuation and whorled configuration of hyper attenuating fluid that suggests recent intra-tumoral hemorrhage in the left kidney
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Fatty tumor extension into the inferior vena cava was also noted (Figure 1, Figure 2).
Axial CT scan showing hypo attenuated tumor thrombus in the inferior vena cava and bilateral pleural effusion
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Fatty tumor extension into the inferior vena cava was also noted (Figure 1, Figure 2).
Axial CT scan after embolization and bilateral nephrectomy.
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Based on the imaging finding, a selective embolization was performed, and a bilateral nephrectomy had been done 8 days later (Figure 3).
Gross specimen of the left kidney showing angiomyolipomatous proliferation of benign appearance (Ex10)
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The histologic evaluation confirmed the presence of adipose tissue, smooth muscle cells and dystrophic vessels (Figure 4).
Axial unenhanced CT scan of the brain shows numerous calcified sub ependymal nodules
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One week later, the patient presents confusion and a brain CT was performed and showed numerous calcified sub ependymal nodules (Figure 5).