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Case Reports
. 2015 Dec 31:5:69.
doi: 10.4103/2156-7514.172977. eCollection 2015.

Perirenal PEComa: Computed Tomography Findings and Differential Diagnosis

Christos V Gkizas  1 , Athina C Tsili  1 , Christos Katsios  2 , Maria I Argyropoulou  1
Affiliations
Case Reports

Perirenal PEComa: Computed Tomography Findings and Differential Diagnosis

Christos V Gkizas et al. J Clin Imaging Sci. .

Abstract

The World Health Organization defines perivascular epithelioid cell tumors (PEComas) as mesenchymal tumors and tumor-like conditions composed of epithelioid cells with a perivascular distribution. These tumors may show benign or malignant histology and/or biological behavior. However, the pathological features of malignancy may not correlate with biologic aggressiveness, and the criteria for malignancy are not clearly defined. Abdominopelvic PEComas are very rare and have been reported in various locations, including kidney, liver, pancreas, gastrointestinal tract, genitourinary tract, peritoneum, and retroperitoneum. Cross-sectional imaging techniques, including computed tomography (CT) may play an important role in the accurate detection and characterization of these tumors. We present the third case of an extremely rare PEComa with perirenal location, discuss CT findings and differential diagnosis.

Keywords: Computed tomography; PEComa; differential diagnosis; perirenal; perivascular epithelioid cell tumors.

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Figures

Figure 1
Figure 1
44-year-old woman with 4-month history of lumbar pain diagnosed with perivascular epithelioid cell tumor. (a) Sagittal sonographic image of the left hypochondrium depicts the presence of a large heterogenous left perirenal mass. The lesion has cystic parts (asterisk) and solid, heterogeneous components (long arrow). The mass is in close proximity to the ipsilateral kidney (arrowhead). (b) Sagittal power Doppler image of the left perirenal mass reveals vascularity of the solid parts (arrowheads).
Figure 2
Figure 2
44-year-old woman with 4-month history of lumbar pain diagnosed with perivascular epithelioid cell tumor. (a) Transverse noncontrast computed tomography image demonstrates inhomogeneous solid parts of the lesion (arrow). The mean computed tomography density of the solid components is 35 HU on unenhanced images, similar to that of normal renal parenchyma. Coronal reformations during (b) the portal phase and (c) the excretory phase depict sharply demarcated left perinephric mass (arrow), partly cystic and solid, in close proximity to the renal capsule. The solid parts of the tumor enhance intensely and heterogeneously, with a mean portal phase attenuation of 100 HU. The left renal parenchyma is intact. Prominent vessels are seen in the left perirenal space adjacent to the lesion (long arrow).
See this image and copyright information in PMC

References

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