We report the case of a 60-year-old male patient with a personal history of hypertension, diabetes mellitus and hypercholesterolemia, diagnosed with a 2.5 cm pulmonary nodule in the right upper lobe, with fibrobronchoscopy and hydrolysis negative in September 1999.
The patient came to our emergency service in August 2004 for a left colic pain of one month of evolution. A clinical history was made with physical examination without abnormalities and rectal examination with well-defined prostatic grade II-III adenomatous.
Complementary examinations were performed with blood tests with values within normal limits and in the abdominal X-ray absence of pelvic calcifications without images compatible with renal lithiasis, in the left renovesical ultrasound was reported terminal ureteral ectasia.
Magnetic resonance imaging was performed in September 2004 reporting a 4.5 cm mass adjacent to the right psoas muscle with minimal contact with the medial margin of the lower renal pole and non-homogeneous uptake compatible with the tumor process.
It was decided to control this lesion with CT that was performed in January 2005 where it was reported the persistence of a hypodense mass with measurements in the range of fat located between the lower pole of the right kidney and angiomyosarcoma 42 mm.
Another hypodense fatty lesion between the inferior vena cava and the right psoas compatible with angiomyolipoma or adenopathy with a fat content of 42 mm was also observed. The left kidney and urinary tract were normal in this case.
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It was decided to perform surgery with laparoscopic right radical nephrectomy and excision of fat mass in paracaval situation.
The patient had an uneventful postoperative period.
The pathological anatomy of the specimen was a glandular tumor formed by mature adipose tissue, fibromuscular tissue and accumulation of myeloid tissue that did not present neighboring structures and with a tumor-free renal vein.
tubulointerstitial atrophy, chronic inflammation and glomeruli.
Right paraureteral myelolipoma.
