Giant renal artery aneurysm mimicking a simple cyst on ultrasound
✍ Scribed by Stuart S. Hantman; Jacob J. Barie; Thomas B. Glendening; Marvin N. Eisenberg; Kenneth D. Rapoport
- Publisher
- John Wiley and Sons
- Year
- 1982
- Tongue
- English
- Weight
- 374 KB
- Volume
- 10
- Category
- Article
- ISSN
- 0091-2751
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✦ Synopsis
Renal artery aneurysms are relatively uncommon. Radiographically, for example, Edsman reported an incidence of only 0.73% in a select group of patients undergoing renal arteriography. At autopsy, however, Schwartz and White demonstrated a greater incidence of 9.7% in randomly selected cadavers2 Smith and Hinman's review of the literature noted the rarity of intrarenal artery aneurysms, which accounted for only 17% of all renal artery aneurysms in the existing literature. Nevertheless, detection of such lesions may be of the utmost importance. Since approximately 20% were associated with rupture and death and an additional 10% required nephrectomy for control of spontaneous hemorrhage, the authors recommended prophylactic removal of the following: all noncalcified aneurysms, large calcified aneurysms, false aneurysms, and any lesion associated with pain, bleeding, or hypertension. Only small calcified aneurysms (less than 1.5 cm in diameter) were felt to represent no danger to asymptomatic normotensive patients3
Renal artery aneurysms may be classified as true or false. False aneurysms usually arise from blunt or penetrating trauma, including iatrogenic trauma (needle biopsy). Of true intrarenal aneurysms, approximately one-third are congenital and two-thirds acquired, divided about evenly between atherosclerosis and polyarteritis n ~d o s a . ~ Recently, Castaneda-Zuniga et a1 reported two cases of giant renal artery aneurysms as unusual manifestations of fibromuscular dy~plasia.~ We believe our case represents a third example of this rare phenomenon. The primary purpose of our case report, however, is to reemphasize a pitfall in the sonographic workup of parapelvic masses.