Association of angiomyolipoma and oncocytoma of the kidney: a case report and review of the literature.
OBJECTIVE
The association between renal carcinoma and angiomyolipoma is rare. Only 14 cases have been reported in the literature. The purpose of this paper is to present an additional case and review the literature on this association.


METHODS
A healthy 42 year old woman was found to have a left flank mass incidentally when she presented for a Papanicolaou smear. The computerised tomography scan revealed a left lower pole renal mass consistent with a renal cell carcinoma. A nephrectomy was performed and the patient recovered uneventfully. The nephrectomy specimen was processed routinely. In addition to haematoxylin and eosin staining, immunohistochemistry for CAM 5.2, vimentin, CD34, antismooth muscle actin, and HMB45 was carried out. Transmission electron microscopy was also performed.


RESULTS
Macroscopically, the lower pole of the kidney contained a well circumscribed, non-encapsulated, tan coloured tumour with a large area of central haemorrhage measuring 10.5 cm. In addition, there was a 0.4 cm poorly circumscribed unencapsulated yellow nodule adjacent to the tumour. Microscopically, the larger tumour showed characteristic features of an oncocytoma. Numerous mitochondria were seen on electron microscopy. The smaller yellow nodule was an angiomyolipoma.


CONCLUSIONS
This paper presents an additional case of oncocytoma associated with angiomyolipoma. Of the 15 cases described in the literature, three were associated with the tuberous sclerosis complex, all from a single study. In tuberous sclerosis, angiomyolipomas are more commonly associated with renal cell carcinoma. If angiomyolipomas are found incidentally in nephrectomy specimens together with other tumours, it is important to exclude tuberous sclerosis retrospectively.
Pillay
K
K
Department of Pathology, Division of Anatomical Pathology, University of Cape Town Medical School/Groote Schuur Hospital, 7925, Cape Town, South Africa. Komala@chempath.uct.ac.za
Lazarus
J
J
Wainwright
H C
HC
D000199:Actins / Q000032:analysis; D018249:Adenoma, Oxyphilic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000328:Adult; D018207:Angiomyolipoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D018952:Antigens, CD34 / Q000032:analysis; D001345:Autoradiography; D015415:Biomarkers; D005260:Female; D006801:Humans; D007633:Keratins / Q000032:analysis; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008854:Microscopy, Electron; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D009392:Nephrectomy; D014057:Tomography, X-Ray Computed; D014402:Tuberous Sclerosis / Q000473:pathology
D000199:Actins; D018952:Antigens, CD34; D015415:Biomarkers; C400901:CAM 5.2 antigen; D007633:Keratins