title: Renal artery aneurysm mimicking renal calculus with hydronephrosis.
abstract: A 51-year-old woman was found to have a left renal calculus with hydronephrosis. She underwent unsuccessful extracorporeal shock wave lithotripsy, leading to the recommendation that percutaneous lithotomy was necessary to remove the renal calculus. In view of the unusual shape of the calculus and absence of abnormalities in urine sediment, preoperative computed tomography and renal angiography were performed, which instead showed a calcified left renal artery aneurysm. Subsequent efforts to perform an aneurysmectomy also failed, eventually necessitating left nephrectomy. This case illustrates the pitfalls in the diagnosis of a renal artery aneurysm, which is a relatively common condition that may have unusual presentations. Hence, it is suggested that the possibility of a renal artery aneurysm be considered in the differential diagnosis when one detects a renal calculus with an unusual appearance. In addition, we propose that 3-dimensional reconstruction computed tomography be performed before considering surgical options for such renal calculi to rule out the possibility of a renal artery aneurysm.
authors.affiliation: Department of Urology, the First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, China.
authors.forename: Shanwen
authors.initials: S
authors.lastname: Chen
authors.forename: Hongzhou
authors.initials: H
authors.lastname: Meng
authors.forename: Min
authors.initials: M
authors.lastname: Cao
authors.forename: Baihua
authors.initials: B
authors.lastname: Shen
mesh_terms: D000783:Aneurysm / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis*; D007669:Kidney Calculi / Q000175:diagnosis*; D008875:Middle Aged; D012077:Renal Artery; D061205:Vascular Calcification / Q000175:diagnosis*