Abstract
Introduction: Bilateral huge perirenal Angiomyolipoma is a very rare entity and has not been reported in the literature to date. The choice of appropriate management for such a rare disease may be a dilemma because each strategy can harbor its own advantages and hazards. Case Presentation: We present our experience with such a patient over seven years of follow-up. Performing surgery in this patient might have ended up in unilateral or bilateral kidney loss, and he refused the surgery and underwent watchful waiting. Conclusions: Like conservative management that was successful for more than seven years. In this case, other treatment options such as angioembolization and surgical resection are vital options with their own risks and benefits.