A 28-year old female presented with fever, chills, and flank pain. Imaging showed a large liver lesion initially thought to be a tumor or abscess. Further CT and MRI revealed the lesion to be retroperitoneal and connected to the upper pole of the right kidney. At surgery, 1.5 liters of pus was drained. Histopathology of the renal mass found it to be an angiomyolipoma, a rare renal tumor. Literature review discussed diagnostic challenges and optimal imaging techniques for diagnosing renal angiomyolipomas.

1. Renal Tumor – Bizarre Presentation Dr Sanjoy Sanyal Consultant Surgeon, Victoria Hospital, Ministry of Health, Seychelles 2005

4. CT Scan preoperative

5. CT Scan preoperative – cont’d This is looking suspiciously like a liver abscess!

6. CT Scan preoperative – cont’d But is it?

7. CT Scan preoperative – cont’d Notice two things.

8. CT Scan preoperative – cont’d

9. CT Scan preoperative – cont’d Notice something more!

10. IVP findings preoperative

12. One and half litre of pus Ureterolysis

13. Postoperative phase

14. CT Scan postoperative

15. CT Scan postoperative – cont’d

16. IVP postoperative Notice two things

17. Revised diagnosis Most probably a renal tumour

19. 2 nd postoperative phase

20. Histopathology report ANGIOMYOLIPOMA of kidney