Sandbox: DDx Kidney mass

Angiomyolipoma

• 25-35 yo males
• Asymptomatic
• Fever, flank pain ,hematuria, hypertension, nausea, vomiting,
• Tuberous sclerosis

• Palpable mass
• Hypovolemic shock if ruptured

• Anemia

• Blood vessels, smooth muscle, and mature adipose tissue
• Hemorrhage and necrosis

• Well circumscribe highly echogenic mass on ultrasonography
• Negative Hounsfield units (HU) on CT scan
• Calcification is rare

• TSC1 and TSC2 gene mutation
• HMB45 Positive

Angiosarcoma

Nonmalignant causes

anaplastic sarcoma clear cell sarcoma mesoblastic nephroma metanephric stromal tumor nephroblastomatosis / nephrogenic rests neuroblastoma oncocytoid carcinoma after neuroblastoma ossifying