Giant Epithelioid Angiomyolipoma: An Imaging-related Differential Diagnosis Among Fat-containing Renal Masses

Renal masses are a common imaging finding andinclude a broad spectrum of both benign and malignanthistopathologic types, with pleomorphic clinicalpresentation and imaging features. Although differentialdiagnosis is often challenging, characterizationis crucial for appropriate management. Angiomyolipomas typically occur as small andasymptomatic lesions incidentally detected while imagingthe abdomen and whose radiologic criterion fordiagnosis is the unequivocal presence of macroscopicfat within the lesion. Rare angiomyolipoma subtypes(such as the epithelioid variant) may reach considerabledimensions and show atypical imaging features,turning into a diagnostic conundrum. Multimodality imaging can guide the differential diagnosisof equivocal fat-containing renal masses andallows lesion characterization.