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Open Access 01-12-2018 | Case report

Varicocele due to renal arteriovenous malformation mimicking a renal tumor: a case report

Published in: Journal of Medical Case Reports | Issue 1/2018

Abstract

Background

Renal arteriovenous malformation is an aberrant vascular connection between the renal artery and vein. Acquired renal arteriovenous malformation (arteriovenous fistulae) accounts for approximately 70% of renal arteriovenous abnormalities. Congenital renal arteriovenous malformation, relatively rare, can result in significant hematuria which may require arterial embolization or nephrectomy.

Case presentation

A 64-year-old Asian man presented to the Urology department in our hospital with gradual left scrotal swelling for 2 years. Ultrasound and computed tomography showed an irregular mass in the upper pole of his left kidney. Digital subtraction angiography confirmed cirsoid-type left renal arteriovenous malformation combined with left renal vein ostial stenosis. After digital subtraction angiography and selective segmental renal artery embolization, the varicocele was obviously alleviated.

Conclusions

The etiology diagnosis of varicocele is not always straightforward, and renal arteriovenous malformation should be considered in the differential diagnosis of varicocele and renal mass. Renal arteriovenous malformation is difficult to distinguish from renal tumor according to varicocele and computed tomography presentation, while magnetic resonance imaging and digital subtraction angiography help to make a definite diagnosis and selective renal angiographic embolization is one of the best treatments for renal arteriovenous malformation.

Sountoulides P, Zachos I, Paschalidis K, et al. Massive hematuria due to a congenital renal arteriovenous malformation mimicking a renal pelvis tumor: a case report. J Med Case Rep. 2008;2:144 doi:https://doi.org/10.1186/1752-1947-2-144 [published Online First: Epub Date].

Donmez FY, Coskun M, Uyusur A, et al. Noninvasive imaging findings of idiopathic renal arteriovenous fistula. Diagn Interv Radiol. 2008;14(2):103–5.PubMed

Yazdani M, Hadi M, Abbasi H, et al. Efficacy of varicocele repair in different age groups. Urology. 2015;86(2):273–5 doi:https://doi.org/10.1016/j.urology.2015.05.004 [published Online First: Epub Date].

Shinsaka H, Fujimoto N, Matsumoto T. A rare case of right varicocele testis caused by a renal cell carcinoma thrombus in the spermatic vein. Int J Urol. 2006;13(6):844–5 doi: https://doi.org/10.1111/j.1442-2042.2006.01421.x [published Online First: Epub Date].

ME V. Rev Med Latino-Am. 1928(14):12

Campbell JE, Davis C, Defade BP, et al. Use of an amplatzer vascular plug for transcatheter embolization of a renal arteriovenous fistula. Vascular. 2009;17(1):40–3.CrossRefPubMed

Crotty KL, Orihuela E, Warren MM. Recent advances in the diagnosis and treatment of renal arteriovenous malformations and fistulas. J Urol. 1993;150(5 Pt 1):1355–9.CrossRefPubMed

Hanna GB, Byrne D, Townell N. Right-sided varicocele as a presentation of right renal tumours. Br J Urol. 1995;75(6):798–9.CrossRefPubMed

Parker DA, Hicks T. Varicocele and renal tumor on right side. Urology. 1975;5(4):530–2.CrossRefPubMed

10.

El Abiad Y, Qarro A. Images in clinical medicine. Acute varicocele revealing renal cancer. N Engl J Med. 2016;374(21):2075 doi:https://doi.org/10.1056/NEJMicm1506668 [published Online First: Epub Date].

11.

Berntsen M, Fode M, Mikines KJ, et al. Recurrence of varicocele caused by renal tumour. Ugeskr Laeger. 2009;171(47):3429–30.PubMed

12.

El-Saeity NS, Sidhu PS. “Scrotal varicocele, exclude a renal tumour”. Is this evidence based? Clin Radiol. 2006;61(7):593–9 doi:https://doi.org/10.1016/j.crad.2006.02.011 [published Online First: Epub Date].

13.

Turkeri LN, Daudi I, Abraham JL, et al. Cirsoid arteriovenous malformation of kidney presenting as a mass suggestive of malignancy. Int J Urol. 1998;5(1):96–8. discussion 99.CrossRefPubMed

14.

Akino H, Gobara M, Suzuki Y, et al. Report of a case of a renal arteriovenous malformation presenting an unusual computed tomographic finding. Hinyokika Kiyo. 1987;33(5):757–61.PubMed

15.

Honda H, Onitsuka H, Naitou S, et al. Renal arteriovenous malformations: CT features. J Comput Assist Tomogr. 1991;15(2):261–4.CrossRefPubMed

16.

Zhang J, Israel GM, Krinsky GA, et al. Masses and pseudomasses of the kidney: imaging spectrum on MR. J Comput Assist Tomogr. 2004;28(5):588–95.CrossRefPubMed

17.

Subramanyam BR, Lefleur RS, Bosniak MA. Renal arteriovenous fistulas and aneurysm: sonographic findings. Radiology. 1983;149(1):261–3 doi:https://doi.org/10.1148/radiology.149.1.6611935 [published Online First: Epub Date].

18.

Somani BK, Nabi G, Thorpe P, et al. Therapeutic transarterial embolisation in the management of benign and malignant renal conditions. Surgeon. 2006;4(6):348–52.CrossRefPubMed

19.

Nakamura H, Uchida H, Kuroda C, et al. Renal arteriovenous malformations: transcatheter embolization and follow-up. AJR. 1981;137(1):113–6 doi:https://doi.org/10.2214/ajr.137.1.113 [published Online First: Epub Date].

20.

Cosgrove MD, Mendez R, Morrow JW. Branch artery ligation for renal arteriovenous fistula. J Urol. 1973;110(6):632–8.CrossRefPubMed

21.

Maruno M, Kiyosue H, Tanoue S, et al. Renal Arteriovenous Shunts: Clinical Features, Imaging Appearance, and Transcatheter Embolization Based on Angioarchitecture. Radiographics. 2016;36(2):580–95 doi:https://doi.org/10.1148/rg.2016150124 [published Online First: Epub Date].

Title: Varicocele due to renal arteriovenous malformation mimicking a renal tumor: a case report
Publication date: 01-12-2018
Published in: Journal of Medical Case Reports / Issue 1/2018
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-017-1546-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Varicocele due to renal arteriovenous malformation mimicking a renal tumor: a case report

Abstract

Background

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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