Surgical management of angiomyolipoma with vena cava thrombus during pregnancy: a case report

Zhenan Zhang, Zhe Liu, Lin Yao, Qian Zhang, Zhisong He

Abstract

Renal angiomyolipoma (AML) can grow and worsen during pregnancy. Sporadic classic variant renal AML with tumor thrombus in the renal vein and inferior vena cava (IVC) during pregnancy is rare. We report a case of complex surgical treatment during pregnancy with normal childbirth. A 27-year-old woman with bilateral AML was faced with large asymptomatic AML and IVC thrombus at 24 weeks of gestation. The magnetic resonance imaging showed that the tumor thrombus had fatty signal. The tumor and IVC thrombus were treated by laparoscopic nephrectomy and open tumor thrombectomy during pregnancy. The patient underwent term spontaneous vaginal delivery at 39 weeks of gestation smoothly and the neonate was in good health. Successful retroperitoneal laparoscopic nephrectomy with open tumor thrombectomy during pregnancy is possible in dealing with invasive renal AML for pregnant patients. Renal AML requires close follow-up during pregnancy. And detailed consult with urologists is necessary before pregnancy.