Abstract

Background: exophytic renal angiomyolipoma and retroperitoneal liposarcoma has completely different management strategies. Unfortunately, confusion may occur on imaging as well as on histopathological analysis hindering definitive diagnosis. We aim to assess certain computed tomography based features which guide to optimal management protocol.

Methods: A retrospective cross sectional study performed in Radiology department, Faculty of Medicine of Zagazig University and at Al-Ahrar teaching hospital. in the period from August 2019 to January 2022. The study was approved by the research ethical committee of Faculty of Medicine, Zagazig University.Two groups of computed tomography scans belong to 19 and 11 cases with exophytic renal angiomyolipoma and perirenal liposarcoma, respectively, were analyzed by two radiologists blinded to the pathological reports for a collection of CT features. These features were compared between both groups using Fisher's exact test.

Results: Renal parenchyma defects in relation to tumor and tumoral vessel connection to the renal cortex were highly suggestive for angiomyolipomas (P < 0.001 for both). Hemorrhage and additional angiomyolipomas are exclusive findings supporting angiomyolipoma diagnosis. Calcifications were detected by both readers only in liposarcomas (P < 0.001). anterior displacement of kidney is significantly higher in frequency among liposarcoma group (P < 0.002). The other observed features were not useful in differentiation (P > 0.055 for both readers)

Conclusion: Careful analysis of certain computed tomography based features of exophytic angiomyolipoma and liposarcoma can direct to definitive diagnosis and consequently to adequate management.

Keywords: CT; Exophytic; Angiomyolipoma; Perirenal; Liposarcoma.