AB158. SOH22ABS154. Renal angiomyolipoma haemorrhage presenting post mechanical fall due to seizure in 32-year-old female: a case presentation

Background: Renal angiomyolipomas are benign mesenchymal hamartomas composed of adipose tissues, tortuous bloods vessels and smooth muscle. The majority occur sporadically, some are associated with tuberous sclerosis disease. Increasing growth bodes an increasing risk of serious bleed, tumours <4 cm have a 50% risk of severe haemorrhage. Patients at increased risk of fall or injury should be aware of their risk of bleed with this tumour type.

Methods: A case of traumatic renal angiomyolipoma haemorrhage after a seizure in a 32-year-old female with intellectual disability, epilepsy and previously established angiomyolipoma. Initial presentation was seizure with continuing somnolence and hemodynamic instability. Diagnosis of acute rupture was made by computed tomography (CT), emergency resuscitation and arterial embolisation was performed.

Results: CT of abdomen and pelvis showed large inferomedial right renal angiomyolipoma of 16×15×13 cm³ with acute ongoing rupture. Multiple small bilateral angiomyolipomas also seen. CT allowed for swift diagnosis and appropriate management in a case with uncommon presentation.

Conclusions: This case report illustrates the risk of angiomyolipoma haemorrhage in patients with established tumours with a history falls risk. This risk increases with the size of the tumour and should be considered in patients who present with fall on a background of known angiomyolipomas. Recognition by the patient and their NOK of their risk may aid in future expeditious diagnoses and improved outcomes by emergency department staff.

Keywords: Renal angiomyolipoma; seizure; haemorrhage; embolisation; computed tomography (CT)