June 30th, 2022

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Cesarean Section Revealing an Unsuspected Renal Angiomyolipoma in a Woman with Severe Hypertension During Pregnancy: A Case Report
Authors:  Stefano R. Giannubilo, M.D., Ph.D., Sara D’Eusanio, M.D., and Andrea Ciavattini, M.D., Ph.D.
BACKGROUND: Renal angiomyolipomas are uncommon during pregnancy, but it is important to consider them in the differential diagnosis, for the increased risk of complications such as bleeding, renal artery compression, and renovascular hypertension.

CASE: A 42-year-old woman was admitted at 34 weeks of gestation for severe abdominal pain in the right flank associated with severe hypertension. During the postadmission immediate cesarean section for fetal compromise, abdominal exploration revealed a massive retroperitoneal hematoma (around 30 cm) up to the cecal region until the lower edge of the liver. The diagnosis was the rupture of a renal angiomyolipoma causing renovascular hypertension.

CONCLUSION: Renovascular hypertension should be considered in patients who present with accelerated hypertension, particularly if the hypertension is resis-tant to medical therapy and not associated with laboratory features of preeclampsia/eclampsia.
Keywords:  angiomyolipoma; Goldblatt syndrome; hemangioma; hypertension, renovascular; lipoma; pregnancy complications; renal artery obstruction
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