Abstract
Angiomyolipoma (AML) is a benign kidney tumor composed of fat tissue, smooth muscle cells, and significant neovascularization, which can lead to spontaneous hemorrhage, causing hematuria and/or retroperitoneal hematoma with back pain. While nephrectomy can be a first-line treatment, embolization is an effective, less invasive alternative. We present a 41-year-old male admitted with left flank pain. Initial ultrasound revealed a heterogeneous hyperechoic mass in the right kidney, and subsequent CT showed a right renal AML with an arterial aneurysm and perirenal fat hematoma. Despite initial hemodynamic stability, a drop in hemoglobin levels necessitated urgent intervention. Interventional radiology performed endovascular embolization with microparticles and coils, resulting in successful devascularization. This case report discusses the clinical presentation, diagnostic workup, treatment strategy, and successful outcome of this complex case.