Simultaneous cesarean section and radical nephrectomy for angiomyolipoma with spontaneous bleeding during pregnancy: a case report.
BACKGROUND
Renal angiomyolipoma with spontaneous bleeding during pregnancy is an extremely rare condition and may jeopardize both the mother and fetus. The ethics of reproductive medicine, method of diagnosis, option for management and optimal time for surgical intervention can be arguable in this situation.


METHODS
A 31-year-old woman presented with dull right flank pain at 12 weeks' gestation. Abdominal sonography and renal magnetic resonance imaging revealed a hypervascular and fat-containing mass with mother and fetus bleeding at the right kidney. Due to stable hemodynamic status, the patient was treated conservatively and underwent elective, simultaneous cesarean section and radical nephrectomy safely at 38 weeks' gestation. Angiomyolipoma of the right kidney was diagnosed on pathologic examination.


CONCLUSIONS
Renal angiomyolipoma with spontaneous bleeding during pregnancy is a dangerous condition that may cause mortality in the mother and fetus, but elective, simultaneous cesarean section and radical nephrectomy can be performed safely if the hemodynamic status is stable.
Koh
Joo-Lee
JL
Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan, ROC.
Lee
Ying-Huei
YH
Kang
Chieh-Yi
CY
Lin
Ching-Nan
CN
D000328:Adult; D018207:Angiomyolipoma / Q000473:pathology / Q000601:surgery*; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology / Q000601:surgery; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*; D011256:Pregnancy Outcome