Date of Presentation:8/17/2022

Attending pathologist: Anil Parwani, MD, PhD, MBA

Presented by: Douglas Wu

Prepared by: Nada Shaker, MD

Organ:kidney

HISTORY:

A 40-year-old male with history of tuberous sclerosis presents with 5 months of painless gross hematuria and mild left sided abdominal pain.

Abdominal MRI showed large masses in bilateral kidneys with areas of fat throughout the renal mass complexes. A large left renal mass appeared morphologically different, without internal fat and with a central stellate scar, measuring 14x11x16cm.

The patient underwent left nephrectomy with tissue sent for histopathological examination.s

GROSS:

Epithelioid angiomyolipomas are large (range 1-25, mean 8.7cm), predominantly solid pink-tan masses frequently containing areas of hemorrhage and necrosis.

Borders can range from well circumscribed to infiltrative, with possible extrarenal extension and involvement of renal veins.

What is the most likely diagnosis?

  1. Clear cell renal cell carcinoma
  2. Chromophobe renal cell carcinoma
  3. Oncocytoma
  4. Epithelioid angiomyolipoma
  5. Epithelioid angiosarcoma
Epithelioid angiomyolipoma