Background:Though rare, angiomyolipoma (AML), is the most common mesenchymal tumour of the kidney. AML is a benign tumour composed of varying amounts of mature adipose tissue, smooth muscle and thick walled blood vessels. The incidence in the general population is between 0.07% and 0.3%. . The association between renal AML and pregnancy is a rare one. The first case of renal AML associated with bleeding in pregnancy was reported in 1964. Since then, only 15 cases have been published in the literature. This is the first report in the literature of a large asymptomatic angiomyolipoma in a solitary functioning kidney found immediately post partum in a 28 year old female.Case Presentation:A 28 year old female was referred to the general surgeons from the labour ward 24hrs post partum with a non tender mass palpable in the right flank detected on routine examination. An ultrasound scan of the abdomen revealed a mass of mixed echogenicity involving and expanding the upper pole of the right kidney. In addition the left kidney was atrophic and non functioning (subsequent radionuclide scan). Consequently a decision to biopsy under ultrasound guidance was made. Histology confirmed a mixed mesenchymal tumour of mature fat, smooth muscle and vasculature, confirming the diagnosis of AML. The patient remained asymptomatic with no deterioration in renal function. She was then referred to a tertiary referral centre for selective embolization of the feeding vessels following which the patient made a complete recovery.Conclusions:The specific risk of renal AML and pregnancy is that of spontaneous haemorrhage and rupture. Although most AML are benign and asymptomatic, the literature suggests that symptoms develop in up to 80% of patients when tumour size reaches 4cm or greater. The most severe and life threatening symptom is that due to haemorrhage. Treatment options for AML include conservative and interventional (total/partial nephrectomy, cryoptherapy, embolization).The current belief is that tumour size should determine whether prophylactic treatment is offered to women of child bearing age due to the possible dangerous (predominantly haemorrhagic) events that may occur in pregnancy. This case provides evidence that it may be possible to continue pregnancy and achieve a normal vaginal delivery when treated conservatively. Patients with angiomyolipoma who intend on becoming pregnant should be counselled about the risks and the option of treating these tumours prophylactically also discussed. Background Though rare, angiomyolipoma (AML), is the most common mesenchymal tumour of the kidney. Initially described by Grawitz in 1900, AML is a benign tumour composed of varying amounts of mature adipose tissue, smooth muscle and thick walled blood vessels1. The incidence in the general population is between 0.07% and 0.3%. Clinically, two distinct presentations of renal AML are usually seen. Between 40 and 80% of patients with tuberous sclerosis have renal AML, which tend to be multiple, bilateral, asymptomatic and often less than 2cm in diameter2. However, approximately 50% of symptomatic AMLs occur in patients who do not have tuberous sclerosis. These tumours usually are single and unilateral. The association between renal AML and pregnancy is a rare one. The specific risk of spontaneous haemorrhage and rupture poses a difficult diagnostic and therapeutic challenge. The first case of renal AML associated with bleeding in pregnancy was reported in 1964. Since then, only 15 cases have been published in the literature3,4,5. There are however no cases in the literature described in the immediate post partum period. This is the first report in the literature of a large asymptomatic angiomyolipoma in a solitary functioning kidney found immediately post partum in a 28 year old female. We review and discuss renal AML in pregnancy, along with its diagnostic and therapeutic challenges. Case History A 28 year old female was referred to the general surgeons fr
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