Renal leiomyoma - case report and literature review

Abstract

Introduction. Leiomyoma is a mesenchymal benign tumor that seldom manifests in the kidney. Typically, these tumors are small, asymptomatic, and often detected accidentally. Differentiating leiomyomas radiologically from other renal neoplasms, particularly renal cell carcinomas, poses a considerable challenge before surgical intervention. Moreover, the conclusive diagnosis of leiomyomas can only be established through histopathological and immunohistochemical evaluation following surgical intervention. Case Report. We present a case of a 44-year-old woman who was diagnosed with right kidney leiomyoma accidentally during a computed tomography examination following exploratory curettage by a gynecologist. An enhanced computed tomography scan revealed a 10 mm tumor located on the upper pole of the right kidney, extending beyond its boundaries. The imaging differential diagnosis was renal cell carcinoma of the right kidney. A laparoscopic partial nephrectomy was performed. Macroscopically, the tumor appeared subcapsular, well-defined, with a firm consistency and a tan-white whorled cut surface. The histological characteristics and the supporting immunohistochemical profile confirmed the diagnosis of renal leiomyoma. The postoperative course was uneventful, and the patient was discharged on the 3rd postoperative day. Conclusion. Leiomyomas are rare kidney tumors. A conclusive diagnosis is established through histopathological findings. The pre-operative differentiation of leiomyomas radiologically from other renal neoplasms, particularly renal cell carcinomas, poses a considerable challenge in radiological assessment.