Post-Embolization Abscess Formation in a Hemorrhagic Renal Angiomyolipoma – A Case Report

Document Type : Original Article

Authors

1 Assistant professor of Radio-diagnosis department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.

2 Lecturer of Radiology, Faculty of medicine, Cairo University, Egypt.

https://doi.org/10.21608/aimj.2025.446654

Abstract

Background: Renal angiomyolipoma (AML) is a benign tumor, but when it grows larger than 4 cm, the risk of bleeding increases significantly. To manage this, arterial embolization is often the go-to minimally invasive treatment. While generally safe and effective, it’s not completely risk-free—one of the rare but important complications is abscess formation after the procedure, which can sometimes be clinically significant.
Case Presentation: We present the case of a 45-year-old woman who came to the hospital with left flank pain. A CT scan revealed a large, hemorrhagic left renal angiomyolipoma measuring 9 cm. To control the bleeding, she underwent successful arterial embolization using gel foam. She was discharged in stable condition with a steady hematocrit. However, 21 days after the procedure, she developed fever, worsening flank pain, and tenderness. A multislice CT scan showed a liquefied mass with an air-fluid level, consistent with an abscess. To treat this, an 8-French pigtail catheter was placed under ultrasound guidance, draining 450 mL of purulent fluid. The catheter was removed after five days, and her symptoms completely resolved. Follow-up imaging at six months showed a small residual lesion (3 cm) without any fluid accumulation.
Conclusion: Abscess formation is a rare but manageable complication following arterial embolization for renal AML. This case highlights the importance of early detection and timely intervention to prevent complications and ensure a positive clinical outcome.
 
 

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