Successful nephrectomy in a woman with ruptured angiomyolipoma after preliminary superselective renal arteries embolization

This case demonstrates a rare case of complexity of operative organ-spare treatment in a patient with congenital anomaly of renal vessels in emergent surgical situation - spontaneous rupture of the left kidney angiomyolipoma, that occurred in the 1st trimester of pregnancy and led to the formation of an extensive retroperitoneal hematoma. Successful resection of the lower pole of the left kidney with a tumor in the presence of vascular anomalies was performed immediately after the selective embolization of the renal arteries. The operation of selective renal arteries embolization provided the optimal subsequent revision of kidney, absence of intraoperative bleeding, and organ-sparing surgery without additional blood loss. The decision on tactics of management of female patients with complicated renal angiomyolipoma during pregnancy should be made collectively by urologists and obstetricians and it should be aimed at the possibility of preserving the fetus. The detection of renal angiomyolipoma is not an indication for termination of pregnancy.

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